Medicare Preferred Provider Organization (PPO)

Medicare Preferred Provider Organization (PPO)  was born when Medicare insurance company and a network of health care providers agree to set the plan for members at contract negotiated rates.

What is PPO?

Medicare Preferred Provider Organization (PPO) is one of the types of a Medicare Advantage plan. In a PPO you will most likely pay lower co-pays as long as you see providers within the network established. You are not required to choose a primary doctor or get referrals from them to see a specialist. Within a PPO plan must provide you with both Medicare part A and B benefits. The plan will include an out-of-pocket cap in order to protect you against enormous spending during a year when you may see higher than normal medical costs. 

General Feature for a PPO plan:

  • Premiums can be lower
  • Medicare Part D Drug Plan
  • “Extra” benefits from some of these plans
  • Changes annually

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