Medicare Advantage: HMO vs. PPO Networks

In addition to costs and understanding yourbenefits, a very important component of selecting the right Medicare Advantage plan for you isunderstanding which network is available to you. In short, a network is a system of providers thatyou're allowed to see under your health insurance plan. There are two options generally underMedicare Advantage plans: HMO and PPO network options. You may be familiar with those terms,HMO and PPO, from other health insurance you may have had through your employer. For example,just like your old employer plan, Medicare Advantage plans may also have different HMOsand PPOs to choose from. At a high level, HMOs, also known as health maintenance organizationplans, have a network of hospitals and doctors. If you want to see a provider outside the network,you will sometimes be required to get a referral..

Generally, though, you will pay the best pricewhen you stick to an in-network provider. PPOs, or Preferred Provider Organizations, are a bitmore broad. They will likely have a bigger network than the HMO. Referrals are generally not neededto see a specialist or out-of-network provider. In the PPO network, the main difference betweenthe two plan types is really just the provider network. If you are staying with your currentdoctor and that's very important to you, just make sure to check that they're in the plan's HMO orPPO network before joining that particular plan.

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