What’s the difference between HMO, PPO, POS, PFFS and SNP Plans? (2024)

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"Thank you so much for all of your help, Todd!!! You have made things a lot less stressful for me!!!!"
- Melody B., Kennebec County, Maine

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I have been on Medicare for 10 years and one short conversation with you explained things better to me than anything I have read before. Thank you for helping me switch plans. We are looking forward to saving $650 a month!
- Bernard M., Cumberland County, Maine

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You have been such a delight to work with. I was completely enveloped in a fog and uncertainty about what to do now that Medicare has crept into my life and you made it crystal clear.
- Dayle S., Cumberland County, Maine

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We contacted Todd with very little time to get enrolled in Medicare in order to avoid late penalties. He came to our home on his day off and got us pointed in the right direction. It took a few days of fast legwork by us and him, but Todd got it done! Todd is right on top of things when time is of the essence and is just a wealth of knowledge and experience on what to expect and when. We highly recommend Todd!
- D.H. & K.P., York County, Maine

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Todd is AMAZING and I would recommend him to anyone that is thinking about retiring or has retired. Todd is honest and willing to go the extra mile. I was so confused when I needed insurance and what would work for me. Todd was so helpful and understanding, he explained options to me and my husband. Todd is an agent that we can email or call anytime and he will respond right away, it is nice to know we have someone that truly cares about what we need.
- Gerry M., Rockingham County, N.H.

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Just a short note to thank you for your time...and very informative intro to Medicare as well as the various nuances to ponder when considering/comparing the pros and cons of an Advantage Program vs. Supplemental Ins. Plans. It feels as though I've known you for years; hopefully our paths will cross in the near future...either in NH or in Maine! At the risk of sounding overly patronizing, you should be "Agent of the Year" in my book! I truly admire your genuine passion and sincere commitment.
- William A., Hillsborough County, N.H.

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Todd Reagin is simply amazing! I had been spending many weeks trying to figure out how to navigate the Medicare system and was completely frustrated and confused. Todd was recommended to me by a health insurance agent from my then existing employer health plan. First of all, he went out of his way to meet me at a time that worked for me. Todd immediately put my mind at ease. He is a true professional with a very warm personality. It is obvious to me that he knows the Medicare system thoroughly and can explain all the many choices available so each person can make an informed decision. I have already recommended Todd to a neighbor and a to a dear friend. I feel a weight has been lifted from my shoulders now that I have Todd in my Medicare corner!!
- Judy J., Oxford County, Maine

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I just so much enjoyed your visit here. It was wonderful. One of the nicest things about your presence here was your open and clear communication. Even your voicemail speaks to that - it's current and explains what's going on. You could well teach of course in Clear Communication.
- Allen P., York County, Maine

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Just wanted to let you know how much I appreciated your help this afternoon. I WISH I'd found you years ago. You are so genuine, knowledgeable, and obviously care very much about the individual's specific needs. You've got a real gift of being able to make a complex subject understandable. You can be sure I'll recommend you to everyone I come across with an insurance need. Thanks again!
- Polly G., Rockingham County, N.H.

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As a business partner for over a decade, I consider Todd to be very professional, with a strong work ethic and a high level of integrity. His attention to detail and exceptional customer service are both stand out qualities appreciated by all his clients.
- Brenda A., Cumberland County, Maine

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Todd, It was a wonderful meeting, and you were so nice, and it's much appreciated. You are such a great guy, and I'm so glad that we have somebody to help with this. Thank you so much.
- Ed M., Penobscot County, Maine

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Deb N.Todd has always provided us with excellent service and dedication. We appreciate his knowledge and timely execution.
- Deb N., Knox County, Maine

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Todd's extensive knowledge of the various Medicare plan options is outstanding. Choosing a plan seemed overwhelming at first, but Todd made it amazingly simple. He is a one stop resource and has the keen ability to cut through all the red tape. The whole process with Todd's assistance was a positive experience. I couldn't be happier with the prompt and professional service that I received.
- Bruce Webber, Cumberland County, Maine

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When I turned 65 I did a huge amount of research to try to understand my Medicare options. I met with a long series of counselors and agents, which left me with conflicting information, many unanswered questions, and no final decision. It was completely overwhelming. I don't live in Maine, but in frustration I began to look for an insurance agent there. What first drew me to Todd Reagin was his informative and personalized website. Both of those qualities characterized his service throughout our interactions. Within one phone consultation he was able to choose the right health insurance plan for me. He listened carefully to my health needs and what I could afford. I was impressed with the initiative he took to investigate my remaining questions and come back quickly with answers. Finally things made sense and I was able to make a confident decision about my plan choice. Todd is very caring, personable, knowledgeable, and motivated to be of service. His service was far better than I received anywhere else. The fact that I don't live in Maine had no impact at all on the quality of service. You should consider working with Todd no matter where you live. Definitely a 5-star experience that sets a new standard for insurance agents. Highly recommended!
- Melissa F., Maine & Florida

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Todd was recommended to us by good friends who have used his services for a number of years. It was my first foray into the scary world of the healthcare exchange and I was dreading it. Todd helped me understand the pros and cons of the options available and what to look for given my healthcare needs. He did not pressure me at all in any direction. He is truly a navigator. He did offer suggestions but was very clear that the decision was mine not his. Thanks to his patience and guidance the experience was very positive. After I had made my decision Todd bird-dogged my application and kept me informed of where it was in the process. I will definitely be contacting Todd next Fall when it is time to enroll. I recommend him highly and without reservation.
- Sue B., Penobscot County, Maine

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Thanks so much for your help regarding my retirement health insurance needs. When you are a "sno-bird" like myself, you want to know what the best plan is for your needs. It is so reassuring to know that in my situation my plan gives me the best coverage, especially while in Florida. Most of all, I do want to thank you for your excellent care and thorough comparisons giving me confidence in this choice. Thanks again!
- Paula M., York County, Maine

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Todd Reagin provides a greatly needed professional service that makes life so much easier for anyone needing insurance. After making a spur-of-the-moment decision to retire, I was very confused as to my options for insurance. Todd provided the information in a way that was so easy to understand. He promised that he would provide all the help I needed and he followed through with every commitment he made. I am grateful for his knowledge and insights, and pleased with what we were able to accomplish easily, stress-free and in a very short period of time.
- Marilyn D., Coos County, N.H.

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I enjoyed working with Todd because it was easy to do so - he understood what we wanted and made it easy for us to move quickly and efficiently through the process. He always watched deadlines for us, and communicated to us in a timely manner. Additionally, Todd's friendly and helpful attitude made our interaction very pleasant. I would recommend him to anyone who needs to know that their work will be done timely, efficiently, and thoroughly.
- Kim F., Cumberland County, Maine

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Todd gave us top notch customer service, prompt response, and was very knowledgeable about his product. I would recommend Todd highly.
- Margaret K., Cumberland County, Maine

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I can't thank you enough for your time and the information you gave me. I'm so happy that I found you and your site and that I will be able to afford a health care insurance plan. I tried to get information from my employer and they never got back to me and you have been so great with so much! It's seriously a huge relief. Thank you thank you thank you!!!
- Vanessa L., Yarmouth, Maine

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Todd is very detail oriented and using his experience and good humor, he helped us stay focused during some challenging times. I would highly recommend Todd.
- John M., Cumberland County, Maine

What’s the difference between HMO, PPO, POS, PFFS and SNP Plans? (2024)

FAQs

What is the difference between HMO, PPO, and pffs? ›

Compared to an HMO or PPO plan, PFFS plans have a more expensive monthly rate and similar costs when you get medical care. Some PFFS plans let your doctor charge you up to an extra 15% on top of what your procedure costs, called balance billing.

What is the difference between HMO and PPO and pos? ›

HMOs will not cover out of network care. With a POS, or point-of-service plan, you also have one PCP who manages your access to other doctors. However, you can visit doctors out of network but it will cost more. With a PPO, or preferred provider organization plan, you don't need a referral to seek additional care.

What is the difference between HMO and PPO Medicare Advantage plans? ›

HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.

What is the difference between a PPO and an HMO include pros and cons for each? ›

HMOs are known for their provider networks and lower costs. They are also restrictive and don't cover out-of-network care unless it's an emergency. PPOs offer more flexibility and allow out-of-network care, but that type of care typically comes with a higher cost.

What does PPO snp mean? ›

Your Medicare SNP may be a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO). Depending on your plan, you may need to see in-network providers to receive coverage, or have the option of going out of network. SNPs are not available everywhere.

Why are people leaving Medicare Advantage plans? ›

Most individuals that dislike a Medicare Advantage plan usually have had a bad experience with in-network providers, plan authorizations for medical care, or having to wait a long time to have an appointment scheduled. Some of these concerns can be attributed to the healthcare provider.

Why do doctors prefer PPO over HMO? ›

The key difference lies in the flexibility of choosing providers and the need for referrals in HMOs. Why do doctors prefer PPO? Doctors often prefer PPOs because they offer greater reimbursem*nt rates compared to HMOs and have less administrative paperwork.

What does POS mean for health insurance? ›

A type of plan in which you pay less if you use doctors, hospitals, and other health care providers that belong to the plan's network. POS plans also require you to get a referral from your primary care doctor in order to see a specialist.

Which is better, HSA or POS? ›

Benefits of PPO vs HSA

An HSA is an additional benefit for people with HDHP to save on medical costs. The PPO is a more flexible health insurance plan for people who have doctors and facilities they use that are out-of-network.

Why do people say not to get a Medicare Advantage plan? ›

Restrictive networks

In some cases, you'll have a higher share of costs when you see an out-of-network doctor. In other cases, you're not covered at all if you go out of network. This is particularly important if you travel a lot because Medicare Advantage plans generally don't provide out-of-state coverage.

Which medicare advantage plan is best? ›

Best for size of network: UnitedHealthcare Medicare Advantage. Best for extra perks: Aetna Medicare Advantage. Best for local support: Blue Cross Blue Shield Medicare Advantage. Best for low-cost plan availability: Humana Medicare Advantage.

What are the negatives of a Medicare Advantage plan? ›

Medicare Advantage offers many benefits to original Medicare, including convenient coverage, multiple plan options, and long-term savings. There are some disadvantages as well, including provider limitations, additional costs, and lack of coverage while traveling.

What is better, HMO pos or PPO? ›

PPO health insurance allows you more freedom to get care anywhere, while a POS plan may allow out-of-network care but demand a primary care referral. A PPO health insurance plan doesn't typically require that you name a primary care provider to oversee your care.

How to tell if you have PPO or HMO? ›

However, if you've already got a health plan and don't know which plan type you have, you can check your insurance card or contact your insurance provider directly. If you have an online account through your provider that allows you to access plan details, you can also start there.

What are the advantages of an HMO or PPO for a Medicare recipient? ›

PPO Medicare Costs. PPO plans tend to have somewhat higher costs than HMO plans, but they generally have larger networks. You also have the flexibility to see doctors out of the network at an additional cost. HMO plan costs tend to be lower than PPO plans as long as you receive care within the network.

What are the disadvantages of PFFs? ›

Disadvantages of PFFS plans

However, premiums with a PFFS plan can cost more than original Medicare, and copayments and coinsurance costs might be high if you go out of network. Also, some providers might not accept your PFFS plan, and some services might be covered while others are not.

What does PFFS mean in health insurance? ›

Medicare Private Fee-for-Service (PFFS) plans are private companies that the federal government pays to administer Medicare benefits.

What is the difference between PPO and HMO vs FFS? ›

While HMO plans offer you fewer provider choices, they usually have the lowest premiums and out-of-pocket costs. On the other hand, PPO plans offer greater flexibility, but they will tend to cost you more out of pocket. Finally, FFS plans allow you to choose any provider you want.

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