Government Advocacy

The Hill doesn’t have to be a climb if you can go straight to the facts.

Engage with a team that advocates on your behalf and translates complex regulations into focused updates on the latest health issues from Washington.

Medicare Advantage

Below members will find helpful links and resources regarding the Medicare Advantage (MA) program and plans.

Common types of MA plans

Local HMOs and PPOs contract with provider networks to deliver Medicare benefits and represent the majority of Medicare Advantage coverage.

Private Fee-for-Service plans (PFFS), as authorized in 1997, were not required to establish networks, but since 2011, have generally been required to do so.

Regional PPOs were established to provide rural beneficiaries greater access to Medicare Advantage plans, and cover entire statewide or multi-state regions.

Special Needs Plans (SNPs), typically HMOs, are designed for beneficiaries who: (1) are dually eligible for Medicare and Medicaid; (2) live in long-term care institutions (or would otherwise require an institutional level of care); or (3) have certain chronic conditions. 

CMS Resources

 

 

 

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