09/01/19 EV.2
Medicare Advantage Plans (Part C) and Cost Plans
Medicare Health Maintenance Organization (HMO) — A Medicare Advantage Plan that provides all
Original Medicare Part A and Part B health coverage and sometimes covers Part D prescription drug
coverage. In most HMOs, you can only get your care from doctors or hospitals in the plan’s network
(except in emergencies).
Medicare HMO Point-of-Service (HMO-POS) — A Medicare Advantage Plan that provides all
Original Medicare Part A and Part B health coverage and sometimes covers Part D prescription drug
coverage. HMO-POS plans may allow you to get some services out of network for a higher
copayment or coinsurance.
Medicare Preferred Provider Organization (PPO) Plan — A Medicare Advantage Plan that provides
all Original Medicare Part A and Part B health coverage and sometimes covers Part D prescription
drug coverage. PPOs have network doctors, providers and hospitals but you can also use out-of-
network providers, usually at a higher cost.
Medicare Private Fee-For-Service (PFFS) Plan — A Medicare Advantage Plan in which you may go
to any Medicare-approved doctor, hospital and provider that accepts the plan’s payment, terms and
conditions and agrees to treat you — not all providers will. If you join a PFFS Plan that has a network,
you can see any of the network providers who have agreed to always treat plan members. You will
usually pay more to see out-of-network providers.
Medicare Special Needs Plan (SNP) — A Medicare Advantage Plan that has a benefit package
designed for people with special health care needs. Examples of the specific groups served include
people who have both Medicare and Medicaid, people who reside in nursing homes, and people
who have certain chronic medical conditions.
Medicare Medical Savings Account (MSA) Plan — MSA Plans combine a high deductible health
plan with a bank account. The plan deposits money from Medicare into the account. You can use it
to pay your medical expenses until your deductible is met.
Medicare Cost Plan — In a Medicare Cost Plan, you can go to providers both in and out of network. If
you get services outside of the plan’s network, your Medicare-covered services will be paid for under
Original Medicare but you will be responsible for Medicare coinsurance and deductibles.
Stand-alone Medicare Prescription Drug Plans (Part D)
Medicare Prescription Drug Plan (PDP) — A stand-alone drug plan that adds prescription drug
coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-For-Service
Plans, and Medicare Medical Savings Account Plans.
Medicare Supplement (Medigap) Products— Insurance plans that help pay some of the out-of-
pocket costs not paid by Original Medicare (Parts A and B) such as deductibles and co-insurance
amounts for Medicare approved services.
Dental/Vision/Hearing Products — Plans offering additional benefits for consumers who are
looking to cover needs for dental, vision, or hearing. These plans are not affiliated or connected to
Medicare.
Hospital Indemnity Products— Plans offering additional benefits; payable to consumers based
upon their medical utilization; sometimes used to defray copays/coinsurance. These plans are not
affiliated or connected to Medicare.
