Preferred Provider Organization (PPO) Plans in Illinois
PPO plans connect beneficiaries to a network of physicians, doctors, nurses, and medical providers who accept the terms of the plan. These networks give beneficiaries access to lower prices when receiving in-network care.
PPO plans don’t require you to select a PCP when you join the plan. This means you have instant access to specialists within the network, without having to first see your PCP for a referral.
One reason that PPO plans are more popular, is because they don’t require subscribers to choose a PCP. In contrast to HMO plans, this benefit allows subscribers to visit specialists without having to receive a referral from their PCP.
Additionally, PPO plans provide a certain level of care out of network coverage. However, beneficiaries will not be able to receive the maximum level of coverage when seeing a provider out of network.
Health Maintenance Organization (HMO) Plan in Illinois
For potential beneficiaries, HMO plans offer affordable medical benefits for seniors in Illinois. These plans are designed to be the most benefit for seniors who are in good health and don’t need intensive medical care.
When you join an HMO, you will have to select a primary care physician. Furthermore, if you need to see a specialist, you will have to visit your PCP for a referral before you can visit a specialist.
Learn more about Illinois HMO Plans.
Private Fee-for-Service Plans (PFFS) in Illinois
One of the most flexible types of Medicare Advantage plans in Illinois, PFFS plans allow beneficiaries to visit any doctor. However, doctors, specialists and other medical providers have the option to accept or reject the terms of the plan each time the patient seeks care.
Learn more about PFFS Plans
Special Needs Plans (SNP) in Illinois
Most Medicare Plans can only be joined by candidates without disabilities, however, SNPs provide Medicare benefits to people with debilitating conditions otherwise not covered under other plans.
Illinois Medicare plans are typically used by beneficiaries above the age of 65. However, Illinois residents with disabilities can receive Medicare benefits under the age of 65. Requirements to join an SNP plan include:
- A diagnosis for End-Stage Renal Disease
- Residence in an extended care facility
- Residence in a nursing home
- Have Medicare Parts A and B
Click the link below to learn more about SNP coverage in Illinois.
Learn more about SNPs
Medicare Supplement Plans in Illinois
Also referred to as a Medigap plan, these MA plans supplement health care costs not covered by Original Medicare. Medigap plans also come with a monthly premium on top of Medicare Part B premiums.
To learn more about Illinois Medigap policies, click the link below.
Learn more about Medigap