Most Medicare Advantage plans do not have a premium. However, you will still need to continue to pay your Part B premium, which is $148.50 as of 2021. If you drop your Part B coverage and stop paying its premium, you will lose your Medicare Advantage coverage. Medicare Advantage plans also have maximum out-of-pocket limits. In 2021, this limit is $7,550.
There are different Medicare Advantage plans that you may want to consider. The most common Medicare Advantage plans are Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO).
Usually, the Health Maintenance Organization (HMO) plan comes with reduced costs. However, it requires you to see providers within their network and get referrals before seeing a specialist. On the other hand, the PPO plan typically costs more but offers more flexible options for visiting providers and may not require referrals to see specialists.
Other plans include:
Private Fee-for-Service (PPFS) - With PFFS plans, you are not required to choose a primary care physician or get referrals for specialists. You can also typically receive care outside the plan’s network, but only if the provider accepts your plan’s terms and conditions. This plan will also choose how much they will pay the healthcare provider and how much you will pay.
Special Needs Plans (SNPs) - SNPs are limited to serving specific individuals who have specific needs. To qualify for an SNP, you must meet one of the following requirements:
- You live in an institutional setting, like a nursing home
- You are eligible for Medicare and Medicaid
- You have a chronic or disabling condition
Medicare Medical Savings Account Loans (MSA) - MSAs combine a high deductible plan with a savings account. You must pay the high deductible before your plan will start providing coverage. However, the plan provider will also deposit funds into a savings account that you can use towards the deductible.