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Doctors Medicare Advantage Plans: What You Need To Know

April 15, 2022

A stethoscope next to a pill with the words medicare advantage written.

Also known as Medicare Part C, Medicare Advantage plans offer a combination of Medicare parts and numerous health services including hearing, dental, vision, and prescription drug coverage.

Even though Medicare Advantage plans are run by private companies, there are many federal safeguards built into them, such as being required to cover everything that is included in the Original Medicare coverage.

A person who has Medicare Part A and Part B and lives in the service area of the plan they want to join is eligible to join a Medicare Advantage plan. It’s just a matter of choosing the plan that best suits your needs.

Choosing the right Medicare plan can seem like a complex and daunting task, especially when it comes to understanding the advantages – and potential disadvantages – of different types of Medicare Advantage plans. To help simplify the process, here are some things you ought to know about Medicare Advantage plans.

Types of Medicare Advantage Plans

There are several types of Medicare Advantage plans from which to choose. The most common plans are:

  • Health Maintenance Organization (HMO) plans – With an HMO plan, you need to select a primary care physician (PCP) who is in the plan’s network. If the services of a specialist are required, your PCP will provide a referral. However, certain services (e.g., annual mammograms) do not require a referral, while other services, such as out-of-area dialysis, may not be offered. In most cases, prescription drugs are covered under an HMO plan. Under some HMO plans, you may be able to go out of network for certain services, but you’ll likely pay the full cost.
  • Preferred Provider Organization (PPO) plans – Like HMO plans, PPO plans have a network of doctors, other healthcare providers, and hospitals that you can use to pay less. The difference is that you don’t have to choose a PCP or obtain a referral to see a specialist. In most cases, prescription drugs are covered, but you should confirm this before joining a PPO plan. If it doesn’t, you cannot join a Medicare prescription drug plan (Part D).
  • Private Fee-for-Service (PFFS) plans – This type of Medicare Advantage plan determines how much it pays doctors and hospitals for your care, and how much you must pay. You don’t have to choose a PCP or obtain a referral to see a specialist. You can use any of the network providers who have agreed to treat PFFS plan members or choose an out-of-network doctor or hospital that accepts the PFFS plan’s terms. However, your costs will probably be higher. Plus, Original Medicare (Parts A & B) will not pay for your health care while you’re on a PFFS plan. If the PFFS plan doesn’t offer drug coverage, you are allowed to join a Medicare prescription drug plan (Part D).
  • Special Needs Plans (SNPs) – This is a Medicare Advantage plan that limits membership to people with specific severe and chronic conditions, such as autoimmune disorders, cardiovascular disorders, cancer, diabetes mellitus, end-stage liver, and renal disease, HIV/AIDS, chronic lung disorders, neurologic disorders, and stroke, just to name a few. Care and services are provided by doctors or hospitals in the SNP network. Medicare prescription drug coverage is provided, and you are usually required to have a primary care doctor and a referral to see a specialist except for certain OB/GYN services.
  • Medicare Medical Savings Account (MSA) plans – An MSA is intended to help self-employed individuals and employees of small businesses save and pay for medical expenses not covered by health insurance. A Medicare MSA plan combines a high-deductible insurance plan with a medical savings plan to pay for health care costs, covering most of the services that Medicare Advantage plans cover with the exception of Medicare Part D prescription drugs. Some MSA plans also cover certain services – such as dental, vision, and long-term care not covered by Medicare – for an extra cost.

The rules for Medicare Advantage plans can change each year, so be certain to review your plan annually.

Medicare Health Services for Seniors in Central and South Florida

Choosing and enrolling in the right Medicare Advantage plan can be a challenging process. Fortunately, you don’t have to deal with it alone. As a provider of senior-focused healthcare services in Florida, we at Palm Medical Centers believe you and your loved ones should receive all the assistance you’re entitled to. That’s why we have dedicated patient relations outreach representatives who work with ACCESS Florida representatives to streamline the process for you.

In addition to providing comprehensive medical care for our patients, we also help them access and obtain social service assistance related to:

  • Medicaid application and renewal
  • Medicare application and plan selections
  • SNAP (Supplemental Nutrition Assistance Program) and meal assistance

To discover all the benefits of becoming a patient at Palm Medical Centers, call us today at (833) 500-PALM (7256) or send us a message now. For your convenience, we have 22 clinics throughout Central and South Florida. We look forward to serving you and your family.

Filed Under: Medicare Provider Tagged With: help with Medicare plans, Medicare Advantage plan in Central Fl, Medicare Advantage plan in south FL, Medicare Advantage plan near me, Medicare part c plan near me, Medicare Provider in Central Florida, medicare services in Central Florida, medicare services in South Florida, medicare services near me

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5 Stars Review

Highly recommend Lou Ann Albano! She is very compassionate, friendly, skillful, attentive, provides excellent care and really listens to you. You are in great hands!

Deanne S.

5 Stars Review

I just wish I could quit forgetting my blood work appointment, but other than that everything is fine. I have been getting great care from Dr. Renan and the office staff is excellent.

Jennifer D.

5 Stars Review

The staff greets me with a smile and by name. There's never a long wait, and Dr. Min is the PC that I have ever had. 15 yrs and counting!

Rose R.

5 Stars Review

I am very happy to be a Patient at Dr Aristides Martinez Office, my appointment yesterday with Andrea was far above expected, she dedicated about one hour to talk with me about all my pains and my concerns. It was like if I would've been with a Psychologist, I came out of her office with all my questions answered and sure that I am in very good hands. I thanks God that I started coming to this Clinic.

Susana Tudda

5 Stars Review

I love Ms. Patel and the girls in the office. I rarely have to wait long. I have been going to this office since it was JayCare in 2015. I have never had a problem with any of the doctors or PAs that I have seen. Ms. Patel actually takes time with me and listens to my concerns. I already recommend her to everyone I know.

Kayleigh Ray

5 Stars Review

Since moving to Florida three years ago I’ve seen many doctors and just didn’t have a good feeling. Once I walked into Dr Shah’s office from the front desk staff to the doctor himself was a wonderful experience. You are always given their undivided attention and Dr. Shah is Very thorough in his exams. I give 5 stars to this office

Annette Gambino

5 Stars Review

Dr Fundora is absolutely incredible, very knowledgeable and caring and her entire staff is amazing too, highly recommended. The receptionists and even the security guards are extremely helpful and friendly, they always remember me when I come in and they’ve all always gone above and beyond to make each experience as easy and stress free as possible.

Louie Blanche

5 Stars Review

We love and trust Dr Cruz. Also their staff is wonderful they’re always happy & have a smile when you go in so it makes you feel better when you’re not feeling so good. I would highly recommend them to everyone and as a matter fact when I changed my insurance this year I made sure he was on the list. Sincerely, A happy patient

Linda Hudson

5 Stars Review

Dr Latt and his staff are AMAZING. Dr Latt takes his time to listen to you and explain everything In detail! The lobby looks amazing, made my heart feel the Spirit of Christmas. My mom was diagnosed with liver failure on Christmas Day and passed 10 days later, 2 years ago and I have really struggled to feel the spirit of Christmas since then. The minute I opened the door and walked into the building pure joy flooded my soul. Thanks to the Staff at Palm Medical for the Amazing Holiday Scene May God Bless you and your families always.

Mrs. Asher

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5 Stars Review

Dr Latt and his staff are AMAZING. Dr Latt takes his time to listen to you and explain everything In detail! The lobby looks amazing, made my heart feel the Spirit of Christmas. My mom was diagnosed with liver failure on Christmas Day and passed 10 days later, 2 years ago and I have really struggled to feel the spirit of Christmas since then. The minute I opened the door and walked into the building pure joy flooded my soul. Thanks to the Staff at Palm Medical for the Amazing Holiday Scene May God Bless you and your families always.

Mrs. Asher

5 Stars Review

Highly recommend Lou Ann Albano! She is very compassionate, friendly, skillful, attentive, provides excellent care and really listens to you. You are in great hands!

Deanne S.

5 Stars Review

I just wish I could quit forgetting my blood work appointment, but other than that everything is fine. I have been getting great care from Dr. Renan and the office staff is excellent.

Jennifer D.

5 Stars Review

The staff greets me with a smile and by name. There's never a long wait, and Dr. Min is the PC that I have ever had. 15 yrs and counting!

Rose R.

5 Stars Review

I am very happy to be a Patient at Dr Aristides Martinez Office, my appointment yesterday with Andrea was far above expected, she dedicated about one hour to talk with me about all my pains and my concerns. It was like if I would've been with a Psychologist, I came out of her office with all my questions answered and sure that I am in very good hands. I thanks God that I started coming to this Clinic.

Susana Tudda

5 Stars Review

I love Ms. Patel and the girls in the office. I rarely have to wait long. I have been going to this office since it was JayCare in 2015. I have never had a problem with any of the doctors or PAs that I have seen. Ms. Patel actually takes time with me and listens to my concerns. I already recommend her to everyone I know.

Kayleigh Ray

5 Stars Review

Since moving to Florida three years ago I’ve seen many doctors and just didn’t have a good feeling. Once I walked into Dr Shah’s office from the front desk staff to the doctor himself was a wonderful experience. You are always given their undivided attention and Dr. Shah is Very thorough in his exams. I give 5 stars to this office

Annette Gambino

5 Stars Review

Dr Fundora is absolutely incredible, very knowledgeable and caring and her entire staff is amazing too, highly recommended. The receptionists and even the security guards are extremely helpful and friendly, they always remember me when I come in and they’ve all always gone above and beyond to make each experience as easy and stress free as possible.

Louie Blanche

5 Stars Review

We love and trust Dr Cruz. Also their staff is wonderful they’re always happy & have a smile when you go in so it makes you feel better when you’re not feeling so good. I would highly recommend them to everyone and as a matter fact when I changed my insurance this year I made sure he was on the list. Sincerely, A happy patient

Linda Hudson

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