Medicare Plans

Medicare plans are health insurance programs through the United States government for older Americans who are 65 years old or older. These health insurance plans can also cover medical needs of young people who are disabled and people who suffer from kidney disease that is in the late stages.

There are five Medicare plans to choose from:

the original or “traditional” plan,
HMOs – Medicare Health Maintenance Organizations,
PPOs – Medicare Preferred Provider Organizations,
PFFS – Medicare Private-Fee-for-Service Plans, and
Medicare Prescription Drug Plans.

You can always choose the traditional Medicare plan and stay with that forever. No matter which plan you choose, you are in the Medicare program. Any plan you choose other than the traditional plan must provide the same coverage as the traditional plan. You can become a new member of any plan as long as the plan has open enrollment.

The Traditional Medicare Plan

The patient can go to any health service provider he chooses that accepts patients who are covered by Medicare.

The traditional Medicare plan pays its part of your health care supplies and services, but it doesn’t cover health care expenses. You must pay your part of the costs. Many people opt to purchase a Medigap policy to cover their costs.

Medicare HMO and PPO Plans

HMO and PPO Medicare plans cover everything the traditional Medicare plan covers. Some HMOs and PPOs cover even more than the original Medicare plan such as prescription drugs, check-ups, vision care and hearing aids. Some of these benefits change from year to year.

An HMO plan requires that the member goes to the doctors, hospitals, and specialists in the HMO network. PPO Medicare plans also have a network of doctors and hospitals to choose from, but these plans also allow the choice of a health care provider outside of the network, but the member will pay more for services.

PFFS Medicare Plans

Private Fee-for-Service (PFFS) Medicare plans allow a senior to choose any health care provider that accepts payments from that plan. The insurance company decides how much you must pay for your health care. Extra benefits may include prescription drug coverage.

Medicare Prescription Drug Plans

Members of the traditional Medicare plan need a prescription drug plan. Many HMO and PPO Medicare plans have a prescription drug plan included.

This is a summary view of the Medicare plans available. There are many websites online that will take your information and help you decide the health care coverage you need.

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