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Prospective Members, Enrolled Members

and Provider Inquiries: 800-405-9681 (TTY 711)

The concept behind Medicare Advantage Plans began when Congress passed the Balanced Budget Act of 1997. Initially known as Medicare+Choice or Part C plans, they became known as Medicare Advantage Plans following the Medicare Prescription Drug, Improvement and Modernization Act of 2003. These plans provide a more coordinated approach to healthcare for older Americans than does traditional, fee-for-service Medicare.

  • Part A (inpatient care)
  • Part B (outpatient and primary care)
  • Part D (prescription drugs)
  • Additional wellness services and care coordination
Senior woman smiling

As part of the legislation that established Medicare Advantage Plans, Congress also created Special Needs Plans (SNPs) to cover the needs of three specialized groups of patients:

  • Those with certain chronic conditions, including COPD, diabetes and cardiovascular care (Chronic Care SNPs or C-SNPs)
  • Those who are eligible for both Medicare and Medicaid (Dual-Eligible or D-SNPs)
  • Those who need a level of care provided by long-term care institutions (Institutional or I-SNPs)

Learn more about Special Needs Plans and Provider Partners Health Plans (PPHP).

Page Last Updated:  10/1/2020

Provider Partner Health Plans are HMO-SNPs with Medicare contracts. Enrollment in Provider Partner Health Plans depends on contract renewal. Y0135_PPHPWEB_2021