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Your Medicare Advantage Coverage Options

What's the difference between HMO, PPO, and POS plans?

HMO (Health Maintenance Organization)

I'm looking for coordinated care and cost savings:

  • Care coordinated through your primary doctor
  • Typically lower premiums
  • Affordable copays for doctor visits

An HMO is a type of Medicare Advantage (Part C) plan that combines Original Medicare (Part A and Part B) into one convenient plan. With an HMO plan, you must receive care from doctors and hospitals within the plan's network, except for emergency or urgent care. Prescription drug coverage is included with most of these plans.

PPO (Preferred Provider Organization)

I'm looking for flexibility and freedom of choice:

  • Access to in-network and out-of-network doctors
  • Coverage when you travel

A PPO is a type of Medicare Advantage (Part C) plan that combines Original Medicare (Part A and Part B) into one convenient plan. With a PPO plan, you can receive care within a network of doctors and hospitals or use out-of-network doctors and hospitals for covered services, usually for a higher cost. Prescription drug coverage is included with most plans.

POS (Point of Service)

I'm looking to do some traveling throughout the year:

  • Coverage when you travel
  • Access to out-of-network coverage

A POS Plan is a type of Medicare Advantage (Part C) plan that combines Original Medicare (Part A and Part B) into one convenient plan. With a POS plan, you need to choose a primary doctor in the plan's network, but you don't need referrals to visit other health care professionals.

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BlueShield of Northeastern New York (BSNENY) is a Medicare Advantage plan with a Medicare contract and enrollment depends on contract renewal. BSNENY is a division of HealthNow New York Inc., an independent licensee of the Blue Cross and Blue Shield Association. BSNENY complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-833-735-4515 (TTY 711). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-833-735-4515 (TTY 711)

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Content Last Updated October 1, 2018