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How do Medicare Advantage PPO plans work?
Preferred provider organization (PPO) plans let you choose any provider who accepts Medicare. You don’t need a referral from a primary care physician for specialist or hospital visits. However, using providers in your plan’s network may cost less.
${company} Medicare Advantage plans at a glance
|
Our PPO plans |
Our HMO plans |
Our HMO-POS plans |
|
|---|---|---|---|
|
Requires you to use a provider network |
No. But seeing out-of-network providers generally costs more. |
Yes, unless it's an emergency |
Varies by plan. Seeing out-of-network providers generally costs more. But most allow non-network dental providers. |
|
Requires you to have a primary care physician (PCP) |
Usually no PCP required |
Yes, in many plans |
Yes, in many plans |
|
Requires referral to see a specialist |
No referral required |
Some plans |
Some plans |
|
Monthly premiums |
Varies by plan, check your ZIP code for details |
Varies by plan, check your ZIP code for details |
Varies by plan, check your ZIP code for details |
|
Medical deductible |
Varies by plan, check your ZIP code for details |
Varies by plan, check your ZIP code for details |
Varies by plan, check your ZIP code for details |
|
Limits what you pay out-of-pocket for medical care each year |
Yes |
Yes |
Yes |
|
Includes prescription drug (Rx) coverage |
Yes, in most plans |
Yes, in most plans |
Yes, in most plans |
|
Includes Rx mail-order benefit |
Yes, if plan has Rx coverage |
Yes, if plan has Rx coverage |
Yes, if plan has Rx coverage |
|
Dental, vision and hearing coverage |
Yes, in most plans |
Yes, in most plans |
Yes, in most plans |
|
ER and urgent care coverage worldwide |
Yes |
Yes, in most plans |
Yes |
|
Fitness benefit |
Yes, through SilverSneakers® |
Yes, in most plans, through SilverSneakers® |
Yes, through SilverSneakers® |
|
Over-the-counter (OTC) benefit |
Yes, in most plans |
Yes, in most plans |
Yes, in most plans |
|
Meals-at-home program (meals delivered after an inpatient hospital or skilled nursing facility stay) |
Yes, in most plans |
Yes, in many plans |
Yes, in most plans |
${company} Medicare Advantage plans at a glance
|
Our PPO plans |
|
|---|---|
|
Requires you to use a provider network |
No. But seeing out-of-network providers generally costs more. |
|
Requires you to have a primary care physician (PCP) |
Usually no PCP required |
|
Requires referral to see a specialist |
No referral required |
|
Monthly premiums |
Varies by plan, check your ZIP code for details |
|
Medical deductible |
Varies by plan, check your ZIP code for details |
|
Limits what you pay out-of-pocket for medical care each year |
Yes |
|
Includes prescription drug (Rx) coverage |
Yes, in most plans |
|
Includes Rx mail-order benefit |
Yes, if plan has Rx coverage |
|
Dental, vision and hearing coverage |
Yes, in most plans |
|
ER and urgent care coverage worldwide |
Yes |
|
Fitness benefit |
Yes, through SilverSneakers® |
|
Over-the-counter (OTC) benefit |
Yes, in most plans |
|
Meals-at-home program (meals delivered after an inpatient hospital or skilled nursing facility stay) |
Yes, in most plans |
|
Our HMO plans |
|
|---|---|
|
Requires you to use a provider network |
Yes, unless it's an emergency |
|
Requires you to have a primary care physician (PCP) |
Yes, in many plans |
|
Requires referral to see a specialist |
Some plans |
|
Monthly premiums |
Varies by plan, check your ZIP code for details |
|
Medical deductible |
Varies by plan, check your ZIP code for details |
|
Limits what you pay out-of-pocket for medical care each year |
Yes |
|
Includes prescription drug (Rx) coverage |
Yes, in most plans |
|
Includes Rx mail-order benefit |
Yes, if plan has Rx coverage |
|
Dental, vision and hearing coverage |
Yes, in most plans |
|
ER and urgent care coverage worldwide |
Yes, in most plans |
|
Fitness benefit |
Yes, in most plans, through SilverSneakers® |
|
Over-the-counter (OTC) benefit |
Yes, in most plans |
|
Meals-at-home program (meals delivered after an inpatient hospital or skilled nursing facility stay) |
Yes, in many plans |
|
Our HMO-POS plans |
|
|---|---|
|
Requires you to use a provider network |
Varies by plan. Seeing out-of-network providers generally costs more. But most allow non-network dental providers. |
|
Requires you to have a primary care physician (PCP) |
Yes, in many plans |
|
Requires referral to see a specialist |
Some plans |
|
Monthly premiums |
Varies by plan, check your ZIP code for details |
|
Medical deductible |
Varies by plan, check your ZIP code for details |
|
Limits what you pay out-of-pocket for medical care each year |
Yes |
|
Includes prescription drug (Rx) coverage |
Yes, in most plans |
|
Includes Rx mail-order benefit |
Yes, if plan has Rx coverage |
|
Dental, vision and hearing coverage |
Yes, in most plans |
|
ER and urgent care coverage worldwide |
Yes |
|
Fitness benefit |
Yes, through SilverSneakers® |
|
Over-the-counter (OTC) benefit |
Yes, in most plans |
|
Meals-at-home program (meals delivered after an inpatient hospital or skilled nursing facility stay) |
Yes, in most plans |
Medicare Advantage plans for every need
In addition to PPO plans, ${company} offers you other Medicare Advantage plan options — many with a $0 monthly plan premium. We can help you find a plan that’s right for you.
${company} Medicare Advantage HMO
With many of our HMO plans, an in-network primary care physician coordinates the care you receive to help you achieve your best health.
${company} Medicare Advantage HMO-POS plans
With our HMO-POS plans, you can enjoy all the benefits of receiving medical care through a network provider. Most of our HMO-POS plans require you to use a network provider for medical care but provide you with flexibility to go to licensed dentists in or out of network for routine dental care.
${company} Medicare Advantage D-SNPs
Our dual-eligible Special Needs Plan (D-SNP) is a type of Medicare Advantage plan, available to people who have both Medicare and Medicaid. We can help you find out if you qualify.
Questions? We’ve got answers
Medicare FAQs
Get answers to common Medicare questions.