Medicare Advantage Plans
Some Medicare beneficiaries will have a Medicare Advantage Plan, which may be referred to as Health Maintenance Organizations (HMOs), or Preferred Provider Organizations (PPOs), instead of the Fee-for-Service (FFS) Medicare plan. Medicare Advantage plans provide care under contract to Medicare. There are several types of Medicare Advantage Plans and are available in many parts of the country. Payment cannot be made under FFS Medicare for beneficiaries enrolled in a Medicare Advantage Plan. Claims for Medicare Advantage Plans should be submitted to the Plan and not to the DME MACs.
See the CMS website for a listing of HMOs.
Last Updated Feb 11, 2020