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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.


Medicare Advantage consists of a variety of products from private insurance companies which substitute for Original Medicare. Today Medicare Advantage includes HMO plans, PPO plans, POS plans, Private Fee-For-Service plans, Medical Savings Account plans and (in a few states) Social/HMO Demonstration Project plans.

Each Medicare Advantage Plan must provide minimum coverage specified by Medicare. A Plan can offer additional services and set its own premiums, deductibles, co-pays and co-insurance. Each Plan must also have appeal procedures. (If a plan does not cover prescription drugs, you can purchase Medicare Part D to cover prescription drugs.

There are special rules with respect to Medicare Advantage HMOs, as well as advantages and disadvantages.

When deciding which medicare advantage plan works for you, take your time to be an informed consumer.

It is easy to enroll or disenroll from a Medicare Advantage plan. You can change Plans every year during a 6 week period known as an Open Enrollment Period. As of 2014, you can also switch plans once a year if the plan to which you switch has a Medicare top five-star quality rating. You can find such plans on Medicare's website at offsite link. Look for the plans with a gold star.

You are protected if a Plan terminates.

To learn how to maximize use of a Medicare Advantage plan, see the following:

How To Maximize Use Of An HMO
How To Maximize Use Of A PPO Health Insurance Policy
How To Maximize Use Of A POS Health Insurance Policy
How To Maximize Fee-For-Service Health Insurance

For more information see:

Frequently Asked Questions

For individual questions about Medicare, consider contacting:

Medicare Advantage: Types Of Plans

Medicare Advantage health insurance is offered through the following types of plans:

  • Original Fee-For-Service Medicare
    • Similar to the old indemnity type insurance plan, Original Fee-For-Service Medicare allows you to use any licensed doctor or other health care provider, and hospital or other facility that accepts Medicare.
    • For a description of the coverage, see Medicare -- Schedule of Benefits.
    • Many people purchase Medigap coverage to supplement the benefits paid by Medicare.
  • Medicare HMO (Health Maintenance Organization)
    • The most common Medicare Advantage product on the market.
    • The government agrees to pay an HMO a flat, monthly fee. In return, the HMO guarantees to provide you all the medical care you need within the benefit schedule provided by the HMO.
    • Just like private HMOs, Medicare HMOs limit your choice of medical provider to doctors, hospitals, and other medical providers who have contracts with the HMO.
    • In addition to copays and deductibles, Medicare HMOs can charge an additional premium.
    • If you are considering switching to a Medicare HMO, see HMO for a thorough discussion of an HMO and how it works.
    • For special rules concerning Medicare Advantage HMOs, click here. 
  • Medicare POS (Point Of Service)
    • A Medicare POS plan lets you choose when you need care (the "point of service") whether to seek it within the plan's network or to pay more money and go outside the network.
  • Medicare PSO (Provider-Sponsored Organization)
    • A Medicare PSO is very much like an HMO except that PSOs are run by doctors and hospitals.
  • Medicare PPO (Preferred Provider Organization)
    • A Medicare PPO is similar to a Point-of-Service plan: you get almost full coverage if you use network providers, and you receive some coverage for care you get from out-of-network providers. 
  • Medicare Private Fee-for-Service (PFFS) Plans
    • A PFFS plan allows you to obtain care from almost any doctor or hospital, but at a higher rate than Original Medicare pays. You'll likely pay more for your care than under Original Medicare because doctors are permitted to charge more than under Original Medicare. 
  • Medicare Fraternal Benefit Society Plan
    • Religious Fraternal Benefit Society Plans are plans offered exclusively to members by a Religious Fraternal Benefit Society. 
  • Medicare MSA (Medical Savings Account)
    • Medical Savings Accounts were created with the idea of providing an inexpensive alternative to regular health insurance for generally healthy people who rarely needed medical care, while still providing catastrophic protection in the event of a serious medical problem.
    • For people who require ongoing medical care due to either a serious or chronic medical condition, Medical Savings Accounts lose their financial advantage.
    • Veterans and people with Medicaid cannot choose this option.
    • Members of MSAs have freedom of choice about choice of doctor, facilities and other medical providers.
    • Medicare pays the premium for an insurance policy with a high deductible (from $1,500 to $6,000 per year). Medicare deposits the difference between the cost of your premium and what it pays for the average beneficiary in your area into your tax-sheltered Medical Savings Account (MSA).
    • You pay medical bills from the MSA until the deductible is reached.
    • There is no limit on what doctors or hospitals can charge you.
    • You have to make up out of your own pocket any difference, with tax deferred deposits to the MSA, between the deductible and what Medicare has paid into your MSA.
    • You may use any excess in your account for any reason. However, unless the money is used to pay medical expenses, you must pay income taxes on withdrawals.
    • See Medical Savings Accounts for more information on how MSAs work
  • Medicare Social/HMO Demonstration Project
    • The Social/HMO Demonstration Project is a pilot project funded by the Health Care Financing Administration and more than 20 private foundations.
    • The  purpose of the tests is to find out whether a single delivery system-based on the HMO model-can provide and coordinate all of an elderly member's health care needs by providing preventive, acute, and long-term care services as an alternative to nursing home care.
    • A Social HMO is an organization that provides the full range of Medicare benefits offered by standard HMOs plus additional chronic care/extended care services. Membership offers other health benefits that are not provided through Medicare alone or most other senior health plans. Services include:
      • Care coordination
      • Medical case management
      • Prescription drug benefits
      • Chronic care benefits covering short term nursing home care, home and community based services such as homemaker, personal care services, adult day care, respite care, and medical transportation.
      • Other services may be offered such as eyeglasses, hearing aids, and dental benefits.
    • There are currently only four Social/HMOs currently operating: Kaiser Permanente in Portland Oregon, SCAN in Long Beach California, Elderplan in Brooklyn, New York, and Health Plan of Nevada in Las Vegas, Nevada. Unlike regular Medicare HMOs, Social/HMOs can and, with the exception of the plan in Las Vegas, do restrict membership to Medicare recipients age 65 and older.  

Medicare Advantage Compared To Original Medicare: Advantages & Disadvantages

The most popular Medicare Advantage plans are HMOs and PPOs.

There are advantages and disadvantages to Medicare Advantage HMOs compared to Original Fee-For Service Medicare. To learn about them, click here.

There are also special rights for HMO participants, as well as rules for what Medicare refers to as Emergency Care and Urgently Needed Care. The rules are important to know when signing up for an HMO -  including what to do if you travel outside the Plan's area or the U.S.  To learn about the special rules, click here.


How To Enroll In A Medicare Advantage Plan

Once you have decided to join a Medicare Advantage Plan, it is a very simple process. The easiest way is to call the company you wish to join. The company will usually send someone out to your home to sign you up. There will be an enrollment form for you to complete.

Confirm everything you're told

No matter how personable or trustworthy the rep seems always call the Plan directly and confirm that the information you've been given is correct. Makes notes of everything you're told during the call, including the name and direct number of the person with whom you speak.

Effective Date

Your coverage will generally be effective on the first of the month following your enrollment. However, if you enroll late in the month your effective date may be postponed until the first of the following month.

When to start using the Plan

Do not start using the Medicare Advantage Plan until you receive notice, preferably in writing, of the date that your coverage is effective. Any charges you incur before your Medicare Advantage Plan coverage is effective will not be covered under the Medicare Advantage Plan.

If you have Original Medicare

The new plan will disenroll you from Original Medicare.

If you have an Original Medicare card, put it away in a safe place. Add the location to your List of Documents so you don't have to remember where you put it. Do not attempt to use the card while you are a member of a Medicare Advantage Plan. If you ever disenroll from a Medicare Advantage Plan and rejoin Original Medicare, you will be issued a new card with the new effective date, but your old card may be of use until you receive the new one.

Join only one plan at a time.

You may belong to only one Medicare plan at a time: either Original or Medicare Advantage Plan or other plan. Should you accidentally enroll in more than one plan with the same effective dates, Medicare will void both enrollments and you will remain in the plan you were in until you complete a new enrollment form. 

To Learn More

How To Disenroll From A Medicare Advantage Plan

Disenrolling from Medicare Advantage has two general situations: disenrolling before coverage begins, and disenrolling after coverage begins.


If you change your mind before coverage starts, call the plan you joined before the date your coverage begins. Tell them you want to cancel your enrollment. Depending on when you call, the plan may ask you to fill out a form to leave.

Particularly if you are told you don't have to complete a form, write down the date, name, title, phone number, and mailing address of the person who told you the cancellation would be effective without your completing any paperwork. Also ask that person to send you written confirmation of your cancellation. Send your own written confirmation of the telephone conversation to the person with whom you spoke.

If you have to complete paperwork, make a photocopy and send it by a means that provides proof of receipt (such as an overnight service or U.S. Mail, Return Receipt Requested.)

Your coverage will remain in the plan you were enrolled in before the change. 

If you enrolled in a Medicare Advantage Plan when you were first eligible for Medicare, you will have the option of going to Original Fee-for-Service Medicare once during the first 12 months of coverage.

After being in a Medicare Advantage Plan for a year, there is a 3-month period each year (January 1 through March 31) during which you can change plans for any reason. The change occurs effective the first day of the following month.

You can also elect to make a change each year between October 15 and December 31. The change is effective the following January 1.

You can also leave at any time if you have cause, such as you were misled, the plan terminates, or you move outside a company's service area.


Medicare Advantage Plans are required to process your request to leave the plan without any delays.

Unless you are enrolling in another Medicare Advantage plan, when you disenroll from a Medicare Advantage Plan you will be returned to Original Medicare.

If you change your mind and want to return to Original Medicare

You can disenroll through your Medicare Advantage Plan. However, you may find it more convenient and less of a problem if you go to your local Social Security office and ask them to process the disenrollment. The Social Security representative will help you complete the disenrollment form, CMS Form 566.

  • Take your Medicare Advantage Plan card with you.
  • Ask the person at Social Security when the Medicare Advantage coverage will stop and you will revert back to Original Medicare. It will usually be the first of the following month. If you apply late in the month, the start date may be postponed until the first of the following month.
  • Get a written receipt from Social Security.

If you want to change from one Medicare Advantage Plan to another Medicare Advantage Plan

The person who enrolls you in the new Medicare Advantage Plan will assist you in disenrolling from the prior Medicare Advantage Plan. The new plan has every incentive to help you disenroll as well as enroll since the new Medicare Advantage Plan will not start getting paid by the federal government until both are completed.