Types of products

There are three types of Medicare Advantage products under the Medicare Modernization Act of 2003:

 

Coordinated care plans

Coordinated care plans use a network of health care providers that have a contract with a health care organization to deliver a CMS-approved benefit package. These include:

• Health maintenance organizations
• Provider sponsored organizations
• Preferred provider organizations

Medicare savings account plans

Medicare savings account plans also use a network of health care providers, but combine a high-deductible benefit package and a medical savings account.

 

Private fee-for-service plans

Private fee-for-service plans are not required to use a network of health care providers.

 

Members can see any health care provider who is eligible to receive payment from Medicare and who agrees to accept payment from the plan.

 

Private fee-for-service plans publish the terms and conditions that health care providers must follow if they choose to provide services to a private fee-for-service member.

 

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Related resources

• Medicare guidelines