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Humana Medicare Advantage Plans include HMO, PPO, & PFFS. Here is a brief description of each…
HMO (Health Maintanence Organization) – An HMO is an alternative to your Medicare coverage. To receive benefits you must use a specific lists of doctors, hospitals, and other providers. If you do not use these “in-network” providers you are not covered (accept for Emergency or Urgent care). HMOs often provide additional benefits not found in Medicare, including coverage for deductibles, a drug benefit plan, and wellness or fitness programs.
PPO (Prefferd Provider Organization – A PPO is an alternative to Medicare coverage. With a Medicare Advantage PPO, you can see any doctor you want. There is still a network of providers thoug. If you use a doctor who participates in this network, you get a better benefit and lower copayment/coinsurance than if you visit a non-network doctor. Another positive of the PPO is you do not need to get referrals from a doctor and you don’t have to see a primary care doctor first. In addition to prescription drug benefits, Medicare Advantage PPOs may offer other benefits such as dental, vision, and nutritional supplements.
PFFS (Private Fee for Service) – A PFFS is an alternative to Medicare coverage. These plans put limits on out-of-pocket expenses, coverage for emergency and urgent care, and in some cases, a prescription drug benefit.
Humana Medicare Supplement
Humana also has Medicare Supplement Plans. Humana Medicare Supplement plans vary by state. Medicare Supplement Plans are also called MediGap plans. If you have Original Medicare (Part A & Part B), you may enroll in Medicare supplement plans to cover expenses not covered by Original Medicare. Medigap plans are independent of Medicare Advantage plans; you cannot have both. Either you have a Medicare Advantage Plan OR you have a MediGap supplemental plan.