A preferred provider organization is a network of physicians, nurses, doctors, surgeons and other providers who agree to give discounted care to plan members. In terms of what are the best kind of Medicare Advantage plans in Indiana, PPO plans are probably the most sought-after type of plan.
When compared to other MA plans like an HMO, PPOs do not require subscribers to select a PCP when they join a plan. Versus an HMO where beneficiaries must select a PCP when they start a plan.
When you don’t have to select a PCP, you can immediately go to visit a specialist without a referral. Many people enjoy the greater flexibility of Indiana PPO plans and the wider range of care. Keep in mind, however, that PPO plans generally have a higher monthly premium to allow for this flexibility. But overall, joining a PPO plan should help you reduce your potential out-of-pocket expenses.
For instance, PPOs usually provide a certain amount of care outside of the main network in contrast to HMO plans that only provide coverage in-network. Just note that you will not receive the maximum coverage benefits if you receive care outside of your plan’s network.
Learn more about Medicare PPO Plans.
Health Maintenance Organization plans are another popular choice for Indiana Medicare beneficiaries. These plans are best for people who are in good health and with few pre-existing conditions. Generally, Indiana HMO plans have lower monthly premiums than PPO plans.
In terms of coverage, HMOs offer coverage for yearly wellness visits, lower out-of-pocket costs for prescription drugs and a PCP to help you manage your care.
When you sign up for an Indiana HMO, you will have to select a PCP who will be your main contact when you need medical care. If you need to see any specialists, you will first need to visit your PCP and receive a referral. If you prefer to find a specialist yourself, you may want to consider joining a PPO plan.
Learn more about Indiana HMO Plans.
Private-fee-for-service Medicare plans are one of the best Advantage plans in Indiana if you value flexibility. A PFFS plan allows beneficiaries to visit any doctor or specialist so long as that provider accepts the terms and conditions of the plan. Providers also reserve the right to accept or reject the plan’s terms each time you visit them.
This might sound like you won’t get to see the same doctor each time you make an appointment, but many providers accept PFFS coverage repeatedly. So, if you’re worried that you can’t build a relationship with your doctor, rest assured that you can when you have a PFFS plan.
Learn more about PFFS Plans.
As stated earlier, most Medicare plans and Medicare Advantage plans can only be joined by seniors age 65 and older. However, if you have been diagnosed with certain conditions, you may qualify for an Indiana Special Needs Medicare plan.
In Indiana, there are three types of SNPs:
- Chronic SNPs (C-SNP)
- Institution-Based SNPs (I-SNP)
- Dual Eligibility SNP (D-SNP)
C-SNPs focus on providing care for persons with debilitating chronic conditions such as End-Stage Renal Disease (ESRD).
I-SNPs provide coverage for people who receive care in a long-term care facility such as a nursing home.
D-SNPs provide coverage for people who are eligible for both Medicare and Medicaid in Indiana.
In order to join an SNP in Indiana, you can either shop for a plan yourself, sign up through the main Medicare website, or speak with an independent health insurance agent licensed to sell Medicare in Indiana.
Learn more about SNPs.
Indiana Medicare Supplement Plans
Also known as Medigap, these plans are used to fill the costs of your health care that are not covered by Medicare A and B. You should know that Indiana Medigap plans come with a monthly premium you’ll have to pay on top of your Medicare Part B premium.
With a Medicare supplement plan in Indiana, you will have extra coverage for hospital stay care, an additional year of hospital stay after Medicare coverage ends, and supplemented Part B prescription costs.
To learn more about your potential Medicare Supplement benefits, talk to one of our Indiana health insurance experts.
Learn more about Medigap.