Medicare Advantage (Part C) provides beneficiaries the chance to get their Medicare benefits through private insurance companies. There are several types of Medicare Advantage plans on the market, and one of the most common are PPO plans. PPO Plans feature a list of healthcare providers that you can choose from.
Medicare Advantage is Part C of the Medicare program. Through Medicare Advantage, people are given the freedom to choose a private insurance company to provide them with their health care benefits. The companies are approved by Medicare.
Medicare Advantage plans are required to provide all of your Part A and Part B benefits, including hospital and medical insurance. This means you get help paying for hospital stays, skilled nursing facility care, hospice care, home health care, preventive health services, and medically necessary services. What else is covered depends on the nature of your Medicare Advantage plan.
A Medicare Advantage PPO is a Medicare Advantage plan AND a Preferred Provider Organization. So, it merges the benefits of an Advantage plan with the choice of a PPO.
Through this PPO, members get access to a network of doctors, hospitals, and other healthcare providers. Choosing to seek care within this network will result in lower costs. You can go outside of the network, but you will pay a little more.
Note: You must choose providers who have opted in to accepts Medicare patients.
PPO plans cover everything that other Medicare plans cover. This means you get Part A and Part B coverage, as well as Part D coverage in some cases. In addition to your core benefits, you can also get extra benefits, which may include:
Whether you need a primary care physician (PCP) or not is based on the nature of your Advantage plan. For PPO plan members, no PCP is necessary. Therefore, you can see a specialist without getting a referral from your PCP—making PPOs plans different from Advantage HMO plans. Keep in mind that a referral may be necessary in some distinct circumstances.
At Overton Agency, we make it easy to find and compare Medicare Advantage plans available in your county. Call to get started today!
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We are not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Currently, we represent 8 organizations which offer 72 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance program (SHIP) to get information on all your options.
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