108 Medicare Terms Defined

Medicare Glossary

Plain-English definitions for every Medicare term — from ABN to ZIP enrollment. No jargon, no confusion.

Showing 2 results for "Referral" — clear search

H

Health Maintenance Organization (HMO)

Part C / Advantage

A type of Medicare Advantage plan where you generally must use doctors, hospitals, and other providers in the plan's network, except in emergencies. You typically need a referral to see a specialist.

Also known as: HMO

Related: Medicare Advantage PPO Provider network Referral
P

Preferred Provider Organization (PPO)

Part C / Advantage

A type of Medicare Advantage plan that allows you to see any provider who accepts Medicare, but you pay less when you use the plan's preferred (in-network) providers. Unlike HMOs, PPOs generally do not require referrals for specialists.

Also known as: PPO

Related: HMO Medicare Advantage Network Referral

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