Harry and Frannie had been on the same Medicare Advantage PPO plan for many years. Frannie now has dementia so they don’t travel like they used to and live a simple life close to home. They have long-time doctors who they like well. Because they no longer need the flexibility of a PPO, we were able to switch them to a Medicare Advantage plan with an HMO while staying with their same insurance company. They can go to their same doctors, but now have lower copays across the board and also have a lower maximum out of pocket cost.

HMOs always cost less than PPOs, but PPOs always offer more flexibility. If you need the freedom to see out-of-network doctors, then a PPO is the solution. PPOs are often helpful to people living in rural communities, those who travel often, and those who want to be treated by out-of-network specialists for specific medical issues.

If you find all Medicare Advantage plans too restrictive, then a Medicare Supplement (MediGap) plan might work better for you. These allow you to see any provider in the United States who accepts Medicare, and don’t have the rules and regulations that Medicare Advantage plans have.