Types of MA Plans
We’ll discuss the types of MA Plans. Click on the images to learn more about each plan.
PFFS
A PFFS plan is a type of MA Plan in which people may go to any Medicare-approved provider if the provider agrees to accept the plan’s terms of payment before treating them. PFFS plans may have extra benefits. The insurance plan, rather than the Medicare Program, decides how much it will pay and what a person will pay for services.
HMO
HMO plan enrollees can generally only go to doctors, specialists, or hospitals that are part of the plan’s network, except in an emergency.
MSA
MSA plans combine a high deductible health plan with a Medical Savings Account that people can use to manage their health care costs. Once a person meets the deductible, the plan covers 100% of Part A and Part B costs. MSAs don’t have premiums. People must still pay a Part B premium. MSA plans don’t cover prescription drugs, but we allow people to enroll in a drug plan.
PPO
PPOs have network providers, but people can also use out-of-network providers for services their plan covers, usually for a higher cost.
SNP
A Special Needs Plan (SNP) offers benefits and services to people with specific diseases, certain health care needs, or limited incomes. SNPs tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups they serve.
Membership in SNPs is limited to certain groups of people, including those in institutions such as nursing homes, those eligible for both Medicare and Medicaid, or those with some chronic or disabling conditions.
