The Advantage of Medicare Advantage PPO Plans
You know that PPO insurance plan you may have had when you were working?
A Medicare Advantage PPO plan works a lot like that. A PPO plan allows you the freedom to choose your healthcare provider. If you had an HMO plan, oh wow, you are really going to love a PPO plan.
A Medicare Advantage PPO plan offers you the ability to see any provider of your choice in or out-of-network. Though it’s not necessary, it could be more beneficial to choose a healthcare provider in the network whenever possible to save money.
How does a Medicare Advantage PPO Plan work
Let’s discuss a PPO plan and how it works. If you are unfamiliar with the term PPO or just need a refresher, it stands for preferred provider organization. A PPO plan provides healthcare coverage with a network of healthcare providers and hospitals. Insurance companies create a contract with the care providers in the network, making it more affordable to visit one of these providers.
Its flexibility is what makes it a popular choice for a Medicare Advantage (Part C) plan. While a PPO plan contracts with a network of care providers, you are not limited to that network, meaning you can choose a healthcare provider outside of the network. You just may have to pay a little more to see a provider who is out-of-network. Most companies who offer PPO plans have large networks so it’s not often difficult to find a provider that you like.
Another advantage of a PPO is that most plans don’t require a referral to see a specialist. This can make it easier to get the specialized care you need. A PPO plan is a great choice as your Medicare Advantage plan, but it is not the only type of plan available.
Comparing PPO and HMO plans
There are a variety of Medicare Advantage plans to choose from and PPO and HMO are two of the most popular types of plans.
PPO and HMO Medicare Advantage plans are pretty similar, but they do have their differences.
The main difference between these two plans is the flexibility of choosing the provider you can see. With an HMO plan, you typically can only see a healthcare provider in the network. Seeing an out-of-network provider could require you to pay the bill entirely out-of-pocket (except in emergency situations). An HMO plan may also require a referral from your primary doctor to visit a specialist. With a PPO plan, you can visit any healthcare provider of your choosing. However, visiting a provider outside of your network generally costs more.
The other major difference between an HMO plan and a PPO plan is the cost. HMO plans tend to have slightly lower care costs, but this depends on the plan and benefits offered. Most people tend to prefer a PPO plan rather than an HMO. However, the type of plan you choose is not the only consideration for finding the right Medicare Advantage plan for you.
Other considerations for choosing a Medicare Advantage Plan
Having access to certain healthcare providers is a major consideration when choosing a Medicare Advantage plan, but it should not be the only thing you consider when choosing a plan.
Here are some additional things to think about when choosing a plan:
- Coverage details
- Premiums and healthcare costs (coinsurance, copays, etc.)
- Supplemental benefits (like dental, hearing, and vision)
- Maximum annual out-of-pocket expenses
- Additional rewards/benefits offered
When choosing a plan, consider your healthcare needs, budget, and lifestyle. Keep these things in mind when exploring the different Medicare Advantage options available in your county.
Find PPO Plans in Your County
The best way to know if a PPO plan is right for you is to explore plan details and compare them to other available plans. Fortunately, this process is easier than ever. Many Medicare plan providers allow you to browse and compare plans online, making it easy to find great plans in your state.
Ready to get started? The only way to know whether a PPO plan is right for you is to dive in and check out the plans offered in your area. Medicare.gov lists all the plans available in your state and county.
If you are looking for a Medicare Advantage PPO plans in Georgia, New Jersey, Pennsylvania, South Carolina, or Texas, then you can also explore the plans Clover offers. You will be glad you did!
