PPO Plans

PPO plans, like all Medicare Advantage plans, function with a network of healthcare providers. Within this network, your out-of-pocket costs will be greatly reduced.

This network is, however, more flexible compared to other Advantage plans. While other options such as Health Maintenance Organization (HMO) plans require in-network care for any coverage, PPO plans allow for a wider range of availability and options for care.

PPO plans do not require a primary care physician or specialist referral. In other words, you can go directly to the doctors and medical professionals you need without visiting your primary doctor first. On top of this, the overall range of the network is larger, including more hospitals, doctors, etc. than other plans.

Here are the primary features of your typical PPO plan:

• Allows for Doctors in More Locations
• No Required Specialist Referral
• No Required Primary Care Doctors

This is the structure of the typical PPO plan. In terms of coverage, all Advantage plans (PPO included) must offer the same benefits as Original Medicare. Many other plans will offer their own competitive benefits, anything from dental, vision, and hearing to prescription drug coverage.