Oct 152012
 

Seniors who are turning 65 and are newly eligible for Medicare Part B are looking for the best rated 2013  Medicare Advantage plans from large insurers like Blue Cross Blue Shield, AARP, Humana, Cigna and many others. Rates for the plans are available for seniors to compare.  While the rates are now available on the Medic are.gov website, rate updates are available on the Florida State insurance website, so Florida seniors that are searching for low cost Medicare Advantage plans can compare offer all available Medicare Advantage plans from a wide range of insurance companies.

For Florida seniors, there is good news. Seniors in that state have access to very many plans from large, trusted insurers. These plans include standalone health plans and Medicare plans that include drug coverage.  Some are HMO plans, while others are PPO’s.

What is the difference between an HMO and a PPO?

Generally, HMO’s (health maintenance organizations)  provide broader coverage for less money per month and with few out-of-pocket costs. HMO’s often limit choice and have much more restricted networks. PPO’s (Preferred Provider Organizations) offer more choice and less restrictions, but usually cost more.


Also, many PPO’s have a deductible of several hundred to a few thousand dollars. This means that the PPO doesn’t pay for coverage until the patient meets their deductible.

 How do I choose the best Medicare Advantage Plan? What does the 5 star Medicare Advantage rating system mean?

Here is a useful video that explains the CMS rating system:

 

Here is a sampling of Medicare Advantage Plans offered:

AARP offers three plans. These plans include their Medicare Complete Choice Plan 1 and Plan 2 (which are HMO plans), and their MedicareComplete Plus which is an HMO – POS plan.

Aetna offers a PPO Medicare Advantage Plan called Medicare Premier, as well as an HMO plan called “Aetna Medicare Value Plan.”

BlueMedicare offers both an HMO and in some Florida regions a regional PPO plan.

Carefree Plus and CareOne Plus offer HMO plans.

Coventry has several choices for seniors. These include the Coventry Summit Ideal Plus HMO plan, a Coventry Vista Ideal HMO plan.

Freedom offers FIVE plans in Florida, providing one HMO plan called the Freedom Medicare Plan.  Four other Medicare Advantage plans are HMO SNP plans called VIP Care, VIP Care for those with COPD, and VIP Savings and VIP Savings COPD.

What is an HMO SNP plan? What does HMO SNP stand for?

HMO SNP plans are Health Maintenance Plans Special Needs Plans. These types of plans are intended for people that have both Medicare A and B and also receive Medicaid. 

Humana offers two HMOS (Humana Gold Plus plans), three PPO plans (HumanaChoice) including two that are regional plans (Humana Reader’s Digest Healthy Living Plan and HumanaChoice Regional PPO.  Finally Humana also offers one plan that is a PFFS plan. The Humana Gold Plus Plans are very highly rated by CMS, rating four-and-a-half stars.


// ]]>
What is a PFFS plan? What does PFFS stand for? 

It stands for “Private Fee for Service Plan,” and refers to a Medicare Advantage plan offered by private insurers.  When using this type of plan, seniors can see any physician that accepts their plan’s terms and conditions for payment. Many PFFS plans may offer a network of physicians and hospitals that have agreed, but the senior may go outside of that network and see whomever they wish, provided that the provider is Medicare-approved AND they are willing to accept the PFFS plan’s terms and conditions of payment.

Medicare Masterpiece Premier plans offer several HMO SNP plans including MMP COPD, MMP Dementia, MMP Diabetes, CHF, and CVD ( for those  seniors with congestive heart failure and cardiovascular disease)

Preferred Choice offers an HMO – POS.  Preferred Gold Option, Preferred Premium Advantage plan and Special Care are available to those in Miami Dade.