PPO Plans
PPO (Preferred Provider Organization) plans are one of the most popular types of Medicare Advantage plans. This plan allows Medicare beneficiaries to go to any in-network healthcare provider or physician they prefer without a referral from their primary care physician. Each Preferred Provider Organization has a list of in-network providers beneficiaries can visit, and they will pay less. However, those that seek services from an out-of-network provider may have to pay more.
How the PPO Plan Works
A Preferred Provider Organization (PPO) is a health insurance plan that consists of medical facilities and professionals such as hospitals, primary and specialty physicians, and other healthcare experts. The healthcare practitioners work closely with the healthcare insurance companies to offer services to subscribers at a reduced price. In exchange for reducing rates, the insurers pay the preferred provider organization a fee to access the network of providers.
When compared to alternative insurance plans, PPO plans are more flexible. PPO networks are huge, with providers in several locations. The ease of accessing or choosing a healthcare provider in emergencies provides value to the subscribers.
Coverage for PPO Plans
Medicare beneficiaries that enroll in a PPO plan will be covered for:
- Medicare Part A (hospital services), including home health care, hospice care, and nursing facility care.
- Medicare Part B (medical insurance), including prevention, diagnosis, and treatment of health conditions.
- Most PPO plans usually offer Medicare Part D (prescription drug coverage)
- Hearing, vision, and dental visits
- Additional health perks, such as transportation and fitness memberships