Preferred Provider Organization (PPO) is a type of Medicare Advantage plan. PPO plans cover a wide network of healthcare professionals, with reduced out-of-pocket costs for in-network services.
When considering which Medicare Advantage plan is right for you, you have to look at all of your options. So, here is everything you need to know about PPO plans and what they have to offer.
What Do PPO Plans Cover?
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.
How Much Do They Cost?
Because private insurance companies offer PPO plans, their costs will vary based on a few factors. Location is a very important factor. Because Florida is a popular retirement state, many insurance companies target the area. You may be able to, then, find competitive rates.
PPO plans cost more than some other Advantage plans. However, they offer a lot more flexibility than other plans. So, by paying a bit more, you will get better coverage—it’s as simple as that.
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