The short answer is that it depends on the area you live in. You can check to confirm if they are offered in your area at Medicare Insurance Plans. There are PPO Advantage Plans that are both local and national. Orange County California has two PPO Advantage Plans, one local and one national. Do you receive additional benefits such as Silver Sneakers? It depends on the plan and company, plus you may receive many more benefits. Is there a cost to a PPO Plan? Yes, there is normally a premium, and remember, you must continue paying your Part B premium. A PPO Advantage Plan is used instead of your Medicare Part A and Part B however you do have a monthly premium and a cost for medical services. You will pay less to use services in-network and you will pay more out-of-network. There may be a deductible for some in-network and out-of-network Medicare-covered services per year.  A PPO also includes a Part D drug plan. To learn more about PPO and HMO Advantage Plans visit Welch Insurance.