Comparing and choosing coverage: How to use charts in this section
This Medicare guide will help you, at a glance, see what plans are available in your area and compare the key benefits each offers. Here are some of the abbreviations and phrases you may see:
■ HMO: Health Maintenance Organizations (HMOs) offer the lowest co-pays and premiums. But they limit you to network doctors and facilities. Your care is coordinated through a primary care physician and referrals usually are required to see specialists.
■ HMO-POS: These hybrid HMOs have a Point of Service (POS) option, allowing you to go outside the plan’s network – but with higher co-pays . You may or may not need a referral.
■ PPO: A Preferred Provider Organization (PPO) allows you to see any physician in their network, no referrals required. Most also provide some out-of-network coverage with higher co-pays. PPOs typically have the highest premiums and costs.
■ SNP: Special Needs Plans offer lower-cost alternatives to those with limited incomes, or who have chronic health conditions. There also are SNPs for nursing home and assisted living residents.
■ PDP: Prescription Drug Plans, or stand-alone plans, offer only drug coverage with no healthcare benefits. They appeal to those who want to stay on traditional Medicare, which does not cover drugs. PDP benefits are the same statewide.
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This phrase in the charts applies to plans that accept what Medicare takes out of your Social Security check as full payment. Some plans may cover part of your Part B premium; others may charge you an additional premium.
■ “Preferred” and “standard” pharmacies: Many plans offer better drug prices through their preferred pharmacy networks, listed in their documents. To get the best plan deal, make a list of all the medications you take and check prices with different insurers.