What Are Medicare Advantage Plans?
Medicare Advantage Plans (also called Medicare Part C) are private health insurance plans approved by Medicare that provide an alternative to Original Medicare (Parts A & B). When you enroll in a Medicare Advantage (MA) Plan, Medicare pays a private insurer to manage your health benefits.
Every Medicare Advantage plan must provide at least the same coverage as Original Medicare, except hospice care, which is still covered under Medicare Part A. Most MA plans also include prescription drug coverage (Part D), along with extra benefits like:
Vision
Dental
Hearing
Wellness programs
To qualify, you must be enrolled in Medicare Part A and Part B and live in the plan’s service area.
Medicare Advantage Plan Types
There are several types of Medicare Advantage plans, but the most common are:
Health Maintenance Organization (HMO) Plans – 2025
HMO Plans are one of the most popular Medicare Advantage options. These plans typically require:
Choosing a primary care doctor (PCP)
Getting referrals to see specialists
Using a network of approved providers
Benefits of HMO Plans:
Lower monthly premiums on average
Coordinated care through your PCP
Many include dental, vision, and hearing benefits
Most include prescription drug coverage (Part D) Out-of-network care is generally not covered, except in emergencies.
HMO plans may be a great option if you want lower costs and don’t mind working within a provider network.
Call us at (877) 413-1556 to learn about HMO plan availability in your ZIP code.
Preferred Provider Organization (PPO) Plans – 2025
PPO Plans offer greater flexibility when choosing doctors and hospitals. You can use providers both inside and outside the network without needing a referral.
Benefits of PPO Plans:
No need to choose a primary care doctor
See specialists without referrals
Out-of-network coverage available (at a higher cost)
Emergency and urgent care covered nationwide
Most plans include Part D prescription coverage
Additional benefits like dental, hearing, and vision
2025 Updates:
The annual cap on Part D out-of-pocket costs is now $2,000
Average monthly premiums for Medicare Advantage plans are around $17.00
PPO plans may have higher premiums or copays than HMO plans, but offer more provider flexibility
Medigap & Medicare Advantage: Important Note
If you enroll in any Medicare Advantage plan (HMO or PPO), your Medigap (Medicare Supplement) policy will no longer coordinate with your new plan. Medigap does not cover any out-of-pocket costs in Medicare Advantage.
You can keep your Medigap plan, but it will not be usable while you’re enrolled in an MA plan. It’s typically not cost-effective to maintain both.
How MedicareMall Can Help
Choosing between an HMO or PPO plan can be confusing—but MedicareMall is here to help. Our licensed, bonded agents will:
Review all plan options in your area
Explain the pros and cons of HMO vs. PPO
Provide quotes from top-rated insurers
Enroll you in a plan that fits your budget and healthcare needs
Call (877) 413-1556 or click the button below to book a free consultation with one of our agents!