Blue Cross Blue Shield Current Medicare Advantage Plans
Health Maintenance Organization
HMO plans only allow in-network coverage. Except for in an emergency, you must use in-network doctors and facilities. You will have a primary care doctor that you choose who manages your healthcare.
These managed care plans are designed to focus on wellness and to help maintain your health. This allows your healthcare provider to catch and treat potential health concerns. This allows them to be treated and potentially avoided.
Preferred Provider Organization
PPO plans to allow you to receive services for your health care from both in and out-of-network providers. You typically don’t need referrals.
You can expect to pay more for services provided out of network. Sometimes, you may be required to pay the total amount upfront and get a reimbursement from the plan.
Private Fee For Service
PFFS comes with or without prescription drug coverage. With a PFFS, you can see any doctor nationwide participating with Medicare. The healthcare provider must agree to take the plan before each visit.
You may add a standalone Part D plan if you have a PFFS without drug coverage. This is the only MAPD that allows the addition of a Part D Prescription Drug Plan.
Special Needs Plan
SNPs are designed for Medicare beneficiaries with specific situations such as certain health conditions, Medicaid, or living in an institutionalized setting.
These plans have benefits that cater to the beneficiaries in this situation. These plans are typically set up as HMO plans and will all include drug coverage.
All Medicare Advantage plans are contracted based on the calendar year, and unless you make a change in a valid enrollment period, the contract renewal will occur automatically.