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August 9, 2010

Medicare Advantage PPO Plans

What is a PPO Plan?

The word "PPO" means "Preferred Provider Organization." A Medicare Advantage plan that delivers its health care coverage through a PPO requires plan members to obtain health care services through one or more of its participating doctors, hospitals, and health care facilities. It is the responsibility of people enrolled in the plan to make sure that the health care providers used participate in the PPO provider's plan. Services rendered by out-of-network doctors and facilities may not be covered or may be paid at a lower level than would be the case for an in-network provider.

Is a PPO Plan Right For You?

A PPO plan may be the right choice if the following conditions apply to you:

  • Your favorite doctor already participates in the PPO
  • You want some freedom to direct your own health care but don't mind working within a list of preferred providers

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Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by private companies approved by Medicare and provide Medicare Part A and Part B coverage. Medicare prescription drug coverage is insurance run by an insurance company or other private company approved by Medicare. A Medicare Supplement plan is a health insurance plan provided by a private company that fills in the "gaps" in original Medicare coverage.

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