MEDICARE PLANS AVAILABLE IN MASSACHUSETTS AND NEW HAMPSHIRE Medicare Advantage Health Maintenance Organizations, HMO, and Preferred Provider Organizations, PPO, are offered through Northeast Business Trust. These are comprehensive group plans that include unlimited prescription drug benefits subject only to small tiered out of pocket co-payments. Medicare Advantage Plans are alternatives to the original Medicare fee for service plan. If a company has fewer than 20 employees, then active employees and retirees who have attained age 65 are eligible to enroll if they have acquired Medicare coverage parts A & B. If the company has more than 20 employees only Medicare eligible retirees are eligible to join a Medicare Advantage Plan. Active working employees must be covered on the company plan. Medicare Advantage HMOs Generally medical services are obtained from doctors and hospitals that join a “network”. Subscribers choose a primary physician, PCP, from the network and the PCP refers to specialists in the network when required. Subscribers can change their PCP at any time and Doctors can join or leave the Medicare HMOs. If the subscriber PCP should leave the HMO will notify the subscriber in advance to give an opportunity to choose a new doctor. If medical services are obtained outside of the network the subscriber will generally pay out of pocket except for emergency and urgent care out of the service area and will be covered. Medicare Advantage PPOs Medicare PPOs use many of the same rules as Medicare HMOs. However in a PPO subscribers can see any doctor or provider that accepts Medicare and is not restricted to local service areas. Subscribers do not need referrals for specialists or provider out-of-network. However the services will generally cost more resulting in higher out-of-pocket costs to the subscriber.