There are several differences in costs and coverage among Original Medicare, Private Fee-for-Service (PFFS) plans, and Health Maintenance Organizations (HMOs). The table below compares these three types of Medicare plans. If you are interested in joining a PFFS plan, make sure to speak to a plan representative for more information.

Go Back

Original Medicare Medicare PFFS Medicare HMO
See any provider and use any facility that accepts Medicare (participating or non-participating) See any provider, but may pay more when seeing out-of-network providers See only in-network providers
 
Visit doctors anywhere in the U.S. Visit doctors anywhere in the U.S., but may pay more when seeing out-of-network providers Visit doctors only in your plan’s service area, except in emergencies or when care is urgently needed
 
Do not need referrals for specialists Do not need referrals for specialists Typically need referrals for specialists
 
Does not cover vision, hearing, or dental services May cover additional services, including vision, hearing, and dental (additional benefits may increase your premium or other out-of-pocket costs) May cover additional services, including vision, hearing, and dental (additional benefits may increase your premium or other out-of-pocket costs)
 
Sign up for a stand-alone prescription drug plan (Part D) Plan may provide prescription drug coverage (if it does not, you can join a stand-alone plan) In most cases, plan provides prescription drug coverage (you may be required to pay higher premium)
 
Charged for standardized Part A and Part B costs (premiums and other cost-sharing for Part D vary depending on plan) Cost-sharing varies depending on plan Cost-sharing varies depending on plan
 
No out-of-pocket limit Annual out-of-pocket limits for in-network and out-of-network care (maximum is $8,850 in 2024) Annual out-of-pocket limit for in-network care (maximum is $8,850 in 2024)
 

If you have Original Medicare, you also have the choice to purchase a supplemental insurance policy, or Medigap. Medigap plans cover Medicare cost-sharing and offer other benefits, but charge an additional premium. You cannot enroll in a Medigap plan if you have Medicare Advantage.