What is a PPO Medicare Advantage Plan?
A Medicare PPO Plan (Preferred Provider Organization) allows you to self-refer (make a doctor appointment) within the provider’s organization without a referral from a primary care physician. This plan also allows you to go outside the provider network for services. The PPO Advantage Plan is a Part C Advantage Plan that gives you the freedom of a PPO plan.
In most areas there are PPO Medicare Advantage Plans, it does depend on your home address. You can check if they are available to you at Medicare Insurance Quotes.
What are the benefits of a PPO Advantage Plan?
- You do not need a referral from a primary care physician.
- You can go out-of-network for services, but it will cost more than in-network)
- It covers your Part A hospital.
- It covers your Part B doctors and outpatient services.
- It may include Part D Drug Plan.
- It may give additional benefits such as dental, vision, hearing, and more.
- There are regional, local, and national PPO networks.
What are the disadvantages of a PPO Medicare Advantage Plan?
- There may be a higher premium than an HMO plan in your area.
- It is not a Medicare Supplement.
- You normally will pay higher copays and coinsurance than an HMO Medicare Advantage Plan.
- The maximum out-of-pocket will usually be higher than an HMO Medicare Advantage Plan.
Who would want a PPO Medicare Advantage Plan?
- If you are new to Medicare and prefer a PPO plan.
- If you do not want to pay for a Medicare Supplement Plan with a stand-alone Part D drug plan.
- If you are on an HMO but want the freedom of being able to make your own referrals and go out- of-network.
- You may live or spend time in more than one state and want the freedom to see doctors when needed.
- You may have developed a health condition and want more choices for treatment.
If you are interested in learning about any Medicare Advantage Plans in your area, Welch Insurance can help you. There is no cost or obligation for our services and we keep our clients updated on any changes. We have a process that helps you decide which plan fits your needs. Visit our Medicare Overview Page.