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Medicare Advantage Plans require patients to seek treatment within a PPO or HMO network.
These plans are more restrictive on doctor and hospital access than traditional Medicare and often include a limited list of approved providers in a specific geographical area.
Medicare Advantage plans also give more authority to the insurance companies as to what is or what is not medically necessary.
- Lower monthly costs or even zero-dollar premium plans available in some areas.
- Limits on doctor and hospital access. Typically restricted to an HMO or PPO network.
- Plans may require Primary Care Physician approval prior to seeing a specialist.
- Most plans include a combination of deductibles, co-pays, and co-insurance.
- In 2024, most Medicare Advantage plans include yearly maximum of up to $8,850.00 in out-of-pocket expenses. Possibly much more if you go out of network.
