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Medicare Advantage PPO Plans

Preferred Provider Organization, or PPO, plans are another type of common Medicare Advantage plan. In the case of PPOs, beneficiaries can receive care from out-of-network providers. These plans also have their own networks, and visiting in-network doctors can help you to keep your out-of-pocket costs low.

Who can you get treatment from?

With PPO plans, you have the option to visit providers within the plan’s network, which can minimize your expenses. However, you do have the option to visit out-of-network physicians, as long as you are willing to assume a higher cost and the physician is willing to accept the plan

As with other plans, you are always covered for emergency room and urgent care services. 

Do you get prescription drug coverage?

Most PPO plans offer drug coverage, and if you are interested in having drug coverage, you must be sure to choose a plan that includes it. If you sign up for a PPO plan without drug coverage, you will not be able to enroll in a separate Medicare drug plan.

Do you need a referral to see a specialist?

Another potential upside of PPO plans is the fact that you don’t have to get a referral to see a specialist, and you can make these appointments on your own. You should keep in mind that seeing an in-network specialist will help to keep your costs lower. 

Along those lines, it isn’t mandatory to choose a primary care physician, though doing so can be helpful when organizing your care. Plus, medical services are not limited to a plan’s network and coverage area.  

Though they tend to have higher premiums than HMO plans, PPO plans are a great option for people who want more flexibility when it comes to choosing their physicians. If you think a PPO plan might be a good fit for you, or you are simply seeking guidance when it comes to exploring your Medicare Advantage options, reach out to a licensed insurance agent here at Medicare Plans Direct today. 

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