More than 27 million adults and people with disabilities rely upon health insurance through Medicare Advantage plans. Medicare Advantage delivers improved services, improved care, better value, and higher levels of satisfaction to the members of the plan.

Several different types of Medicare Advantage plans are available. Most fall into one of the following categories:

Health Maintenance Organization (HMO) Plans: In a Medicare Advantage HMO plan, the beneficiary must receive all services and medical care from providers who are involved in the plan’s network. However, this restriction does not apply to emergency care, out-of-area urgent care, and out-of-area dialysis.

Preferred Provider Organization (PPO) Plans: In a Medicare Advantage PPO plan, the beneficiary relies upon doctors, health care providers, and hospitals involved in a network. A beneficiary using the preferred providers will have to pay less in co-payments. A beneficiary, if he or she prefers, may still consult with a doctor or get the health care services outside the network, however this may result in higher cost.

Private Fee for Service (PFFS) Plans: In a PFFS Medicare Advantage plan, a private insurance company provides the beneficiary with all benefits the beneficiary would have received under Original Medicare Parts A and B, together with any other benefits which the insurance company wishes to provide under the plan. A PFFS plan does not restrict the beneficiary’s choice to specific providers. The beneficiary may use any provider willing to accept the plan’s financial terms and conditions.

Special Needs Plans (SNPs): A Medicare Advantage SNP is a plan similar to HMO or PPO plans. However, Medicare Special Needs Plans offer limited membership to individuals suffering from a particular disease or having a particular disability. In Special Needs Plans, the members have benefits, drug formularies, and provider choices designed to meet all the particular needs of the specific group or condition treated. Some SNP’s will cover out-of-network services and providers, while others won’t

The issue of coverage is particularly important with SNP’s, as, by definition, beneficiaries have special, often difficult, needs that rely heavily upon consultation with specialists. Before selecting a particular SNP, the beneficiary must determine in advance that his or her preferred specialist participates in the network.

In choosing a particular Medicare Advantage plan, a beneficiary should be aware of the goals and design of the program when it was founded:

Overwhelming support for Medicare Advantage: Medicare Advantage programs enjoy overwhelming customer satisfaction and support. It is estimated that more than 94% of the beneficiaries of Medicare Advantage plans are satisfied with their coverage. Given this overwhelming response, Medicare Advantage plans have gained strong bipartisan political support.