MA and other Health Plans may have limitations on the providers that you can see and hospitals you can use. This is often referred to as a network provider list.
MA/other Medicare health plans available in South Dakota include:
- HMO (Health Maintenance Organization). You must use doctors and hospitals in the network. If you receive care out of the network, you may pay more or the plan MAY NOT pay at all.
- Medicare Cost Plan. Similar to an HMO, but services received outside the plan are covered under Original Medicare.
- PPO (Preferred Provider Organization). You must use preferred doctors and hospitals, or pay more.
- PFFS (Private Fee-for-Service). You may use any doctor or facility that accepts the plans terms. If they don’t you will need to choose another doctor or hospital, or pay more.
MA Health Plans may offer benefits original Medicare does not, such as limited dental, vision, and fitness benefits.