PPO Plans
Preferred Provider Organization (PPO) is a type of Medicare Advantage plan with great flexibility and coverage.
Medicare Advantage and PPO Plans
Medicare Advantage is considered an “all-in-one” alternative to Original Medicare. While you’re still required to pay your Original Medicare premium and deductibles separately from your Advantage premium, an Advantage plan will reduce your out-of-pocket costs for Part A and Part B benefits, as well as provide many additional benefits.
Advantage plans are required by law to include all of the same coverage as Original Medicare. Additional benefits will vary based on the provider you choose. Be sure to compare options in your area to find the best plan for you.
Other Types of Advantage Plans
Besides PPO, there are four other types of Advantage plans:
- Health Maintenance Organization (HMO)
- Private Fee-For-Service (PFFS)
- Medical Savings Account (MSA)
- Special Needs Plans (SNPs)
What Else You Should Know
Preferred Provider Organization (PPO) plans provide coverage within a network of doctors, offices, hospitals, etc. that your plan has negotiated and agreed to work with them. By agreeing to their plan, you can use in-network care to lower out-of-pocket costs.
While your costs are significantly lower in-network, PPOs do allow for some coverage out of their network. However, staying inside of it shouldn’t be difficult in normal circumstances.
You can also see a specialist without a referral, and still be covered. PPOs, as well as other Advantage plans, also cover additional benefits such as:
- Limited dental, vision, and hearing
- Prescription drugs
- And more!
PPO vs. HMO Plans
The closest alternative to PPO is a Health Maintenance Organization (HMO) plan. If you would rather pay less than a PPO in exchange for less flexibility, you may be more interested in an HMO.
HMOs cost less than PPO plans, offering a smaller network and the choice of a primary care physician for specialist referral. They don’t offer coverage out-of-network.
Both plans are widely available, and it won’t be hard to find one in your area that best suits your needs. The choice between these types of plans, then, is up to what you’re looking for — flexibility or the lowest possible costs.
Pursue the Path to a PPO Plan
If you want to take the next step towards your own PPO plan, or still need help deciding, call Priority Health Insurance Services at 626-966-1098, or email info@priorityhealthins.com.
