Medicare Advantage PPO Plans

Medicare Advantage has 5 different plans to choose from, including Preferred Provider Organization (PPO). These plans are well-suited for those who want flexibility, but still want the cost-convenience of a network. 

How a PPO Plan Works

We understand that these are probably unfamiliar terms. Let’s break down the main features of a PPO plan:

  • Network: You have the option to receive your care from an in-network provider with your plan and pay less, but you also have the option to go outside this network and get care. However, you will pay more in out-of-pocket costs with this option.
  • Primary Care Doctor: A primary care doctor is your in-network person to visit first before anyone else, except in the case of an emergency. If you are required to have a primary care doctor, you will not be able to choose the doctor you visit for a particular need. PPO plans do not require a primary care doctor, meaning you can go straight to the specialist that you believe can help you.
  • Specialist Referral: Some Advantage plans require a specialist referral from your primary care physician before you can receive covered treatment, even if it is in network. With a PPO plan, this isn’t required.

What PPO Covers

You now have more of an idea of what a PPO plan will cover. Here are the main features of a PPO plan’s coverage:

  • Allows for out-of-network visits
  • Does not require a primary care doctor
  • Does not require specialist referrals
  • Covers prescription drugs

As you can see, PPO plans (and almost every other Advantage plan) also include Part D prescription drug coverage. This is a fantastic and necessary benefit for many Medicare recipients. 

Most Advantage plans will also have some form of limited dental, vision, and hearing coverage, and more.

The Cost of a PPO Plan

Like all Medicare Advantage plans, PPO prices will vary depending on the provider and your location. For Medicare recipients, PPO plans are, on average, $30 a month. Some Medicare Advantage premiums may be as low as $0 for certain plans.

To learn more about the cost of a PPO plan in your area, we can help.

Learn More About Medicare Advantage—Call The Coleman Agency

There is no one like The Coleman Agency that will help you understand your Medicare. Our team will make the complicated simple, and make sure that you are confident in your coverage. To get started, give us a call today.

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