Page Guide:

What is Medicare Advantage?

Medicare Advantage PPOs

Medicare Advantage HMOs

Medicare Advantage PFFSs

Get A Quote

What is Medicare Advantage?

Medicare Part C, also known as Medicare Advantage program, is meant for individuals that would prefer to get their benefits from private insurance companies rather than Original Medicare. A Medicare PFFS Plan is a type of Medicare Advantage Plan (Part C) offered by a private insurance company. PFFS plans aren’t the same as Original Medicare or Medigap. The plan determines how much it will pay doctors, other health care providers, and hospitals, and how much you must pay when you get care.


Eligibility for Part C requires that you be enrolled in both Medicare Parts A & B. Medicare Part A & B coverage must be maintained, in order to remain eligible for Part C coverage.

How does Medicare Advantage Coverage work?

Medicare Part C private insurance plans often have an HMO or PPO network of doctors.

Quick Overview:

Who is eligible for Medicare?

Eligibility for Medicare is based on a few qualifying conditions:

  • You are 65 or older
  • You are younger than 65 but have been classified as disabled for longer than two years, and have received checks Social Security Disability checks
  • You are eligible to receive benefits from Social Security
  • You are an United States Citizen OR you have legally resided in the United States for man than 5 years
  • You have Lou Gehrig Disease
  • You have End-Stage Renal Disease

When can I begin my enrollment?

Each year, Medicare has an open enrollment period that begins on October 15th and concludes December 7th. This enrollment period allows you to change, add, or drop your coverage.

Additionally, you are allowed to enroll throughout the year, under what is called is a special enrollment period which is when one of the following occurs:

  • You move
  • You lose group insurance coverage
  • You are dual eligible
  • You have a qualifying chronic condition

How do I begin my enrollment?

Contact Reversus Insurance Solutions through our website or reach out to us directly.

Our agents will take you through the process of:

  • Providing you with rate comparisons
  • Matching your insurance coverage to your lifestyle
  • File all paperwork with the carrier and handle any issue that you may encounter during enrollment

What are Medicare Advantage PPOs?

PPO Medicare Advantage Coverage stands for Preferred Provider Organization. This means that you get access to a private alternative to “Original Medicare”. You are able to seek any form of treatment within the insurance carrier’s network without a referral. This PPO Plan also allows you to:

  • Save time visiting your Primary Care Physician to receive a referral, as with an HMO
  • Seek treatment directly from the Specialists you choose within your insurance carrier’s network


Some other advantages of PPOs include:

  • Part D Prescription Drug Plans are typically integrated into Medicare Advantage PPOs
  • Some PPOs may offer vision exams and gym memberships as part of your coverage
  • Medicare Advantage PPOs typically have lower premiums than Medicare Supplement policies
  • It is a “pay-as-needed” service - You will have lower premiums but typically will pay more out of pocket for your doctor’s visits, hospital stays, surgeries, medical equipment, lab-work, and other healthcare related procedures.


What are Medicare Advantage HMOs?

HMO Medicare Advantage Coverage stands for Health Maintenance Organization. This means that you get access to a private alternative to “Original Medicare”. You are assigned a P.C.P. (Primary Care Physician) within your insurance carrier’s network and should you require a specialist, get referred by your P.C.P. to a specialist within your network . This HMO Plan also allows you to:

  • Save money visiting your P.C.P.
  • Save money on healthcare related procedures such as hospital stays, surgeries, medical equipment, lab-work, etc.
  • Seek treatment from Specialists within your insurance carrier’s network, so long as your P.C.P. refers you to them


Some other advantages of HMOs include:

  • Depending on the insurance carrier you select, Premiums may be as low as $0
  • Receive a P.C.P. that can coordinate all of your care and referrals to Specialists
  • Are often time subject to little to nothing out of pocket - Just copay fees should they be applicable


What are Medicare Advantage PFFSs?

PFFS Medicare Advantage Coverage stands for Private Fee-For-Service Plan. This means that you get access to a private alternative to “Original Medicare”. Your plan will determine how much it will pay doctors and other healthcare providers, and how much you must pay when you get care. This PFFS Plan also allows you to:

  • Present your Medicare PFFS Plan ID Card to any Medicare participating provider, and if the provider accepts, receive treatment at the terms and conditions of your plan
  • Skip maintaining a P.C.P. (Primary Care Physician) with this plan
  • See a Specialist without a referral


Some other advantages of PFFSs include:

  • Some PFFS Plans contract with network providers who agreed to treat you, even if you’ve never seen them before
  • You may visit any Medicare participating provider, and so long as they accept your plan’s payment terms, receive treatment
  • In an emergency, doctors, hospitals, and other providers must treat you


Types of Medicare

Part A

Hospital Insurance

The rich text element allows you to create and format headings, paragraphs, blockquotes, images, and video all in one place instead of having to add and format them individually. Just double-click and easily create content.

Static and dynamic content editing

A rich text element can be used with static or dynamic content. For static content, just drop it into any page and begin editing. For dynamic content, add a rich text field to any collection and then connect a rich text element to that field in the settings panel. Voila!

How to customize formatting for each rich text

Headings, paragraphs, blockquotes, figures, images, and figure captions can all be styled after a class is added to the rich text element using the "When inside of" nested selector system.

Part B

Medical Insurance

The rich text element allows you to create and format headings, paragraphs, blockquotes, images, and video all in one place instead of having to add and format them individually. Just double-click and easily create content.

Static and dynamic content editing

A rich text element can be used with static or dynamic content. For static content, just drop it into any page and begin editing. For dynamic content, add a rich text field to any collection and then connect a rich text element to that field in the settings panel. Voila!

How to customize formatting for each rich text

Headings, paragraphs, blockquotes, figures, images, and figure captions can all be styled after a class is added to the rich text element using the "When inside of" nested selector system.

Part C

Medicare Advantage

The rich text element allows you to create and format headings, paragraphs, blockquotes, images, and video all in one place instead of having to add and format them individually. Just double-click and easily create content.

Static and dynamic content editing

A rich text element can be used with static or dynamic content. For static content, just drop it into any page and begin editing. For dynamic content, add a rich text field to any collection and then connect a rich text element to that field in the settings panel. Voila!

How to customize formatting for each rich text

Headings, paragraphs, blockquotes, figures, images, and figure captions can all be styled after a class is added to the rich text element using the "When inside of" nested selector system.

Part D

Prescription Drug Coverage

The rich text element allows you to create and format headings, paragraphs, blockquotes, images, and video all in one place instead of having to add and format them individually. Just double-click and easily create content.

Static and dynamic content editing

A rich text element can be used with static or dynamic content. For static content, just drop it into any page and begin editing. For dynamic content, add a rich text field to any collection and then connect a rich text element to that field in the settings panel. Voila!

How to customize formatting for each rich text

Headings, paragraphs, blockquotes, figures, images, and figure captions can all be styled after a class is added to the rich text element using the "When inside of" nested selector system.

Get A Quote

By submitting this information you acknowledge a licensed insurance agent may contact you by phone, email or mail to discuss Medicare Advantage Plans, Medicare Supplement Insurance or Prescription Drug Plans.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Heading

The Names You Recognize & Many More: