When you sign up for a Medicare Advantage plan, there are a couple of different Medicare Advantage plan structures to choose from. Medicare Advantage PPO is a type of Medicare Advantage plan available through private insurance companies approved by Medicare to provide and manage benefits for Medicare recipients.
What is a Medicare Advantage PPO?
Medicare Advantage PPO is a type of Medicare Part C plan that you can join as an alternative to Original Medicare. As the name implies, Preferred Provider Organization plans make use of a network of preferred providers to establish the amount you will be required to pay for services rendered. However, unlike HMOs, PPO plans allow their members to receive care outside of the provider network if they choose to.
With Medicare Advantage PPO, you will generally pay lower copays if you see doctors or hospitals in your network. However, if you see providers outside of your network, you will pay more.
Since Medicare Advantage PPO is a part of the Medicare Advantage program, it must cover all the benefits offered by Original Medicare.
Who is Eligible for Medicare Advantage PPO Plan?
To enroll in any Medicare Advantage plan, you must first be enrolled in Original Medicare. The first time you can enroll in a Medicare Advantage plan is during the Initial Enrollment Period, which is a seven-month period that surrounds your 65th birthday. You may also enroll during the Annual Enrollment Period from October 15 to December 7.
Medicare Advantage PPO Costs
The cost of a Medicare Advantage PPO mostly depends on the services offered and other factors. But generally, you will pay a monthly premium for Medicare Advantage PPO in addition to your Medicare Part B premium. In 2023, the standard cost of Part B is $148.50 per month. This could be higher depending on your income.
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Learn More About Medicare Advantage PPO
At Heritage First, we specialize in Medicare plans and can provide you with all the information you need to choose a plan that works for you. Contact us today to determine whether a Medicare Advantage PPO would be suitable for your needs and budget.
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