Medicare Plus (+) Choice (M+C) plans offer a number of health care options in addition to those available under Medicare Part A and Part B. It was created under the Balanced Budget Act (BBA) in 1997. Plans may include health maintenance organizations (HMOs), fee-for-service plans, provider-sponsored organizations (PPOs), point-of-service (POS) plans, provider-sponsored organizations (PSOs), religious fraternal benefit society plans (RFPs), and Medicare medical savings accounts (MSAs). Also see Medicare Plus (+) Choice (M+C) plan and zero premium plan .