How Does a PPO Plan Work?
Preferred Provider Organization (PPO) plans are a type of Medicare Advantage Plan (also known as Medicare Part C) that include all Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) benefits. Medicare Part C plans are designed to reduce the cost of healthcare by contracting with certain doctors, labs, and hospitals to provide care at a discounted rate for members. A PPO plan has a list (called a "network") of primary care physicians, specialists, hospitals, and other providers that you may go to. You have the flexibility to go to any doctors, specialists, or hospitals that aren't on the plan's list. However, you might pay more for services that are received outside of the network. In addition, special rules for authorization may apply. PPO plans may also include Medicare Part D prescription drug coverage.
Enroll in a Medicare Advantage PPO Plan Today!
You may be eligible to enroll in a Medicare Advantage plan during your Initial Coverage Election Period (ICEP), when you become eligible for Medicare Parts A and B. This is usually during the three months prior, the month of, and the three months after your 65th birthday month or your 25th month of disability.
Medicare's Special Election Period allows you to enroll in a Medicare Advantage plan if you meet other conditions. Find a list of qualifying conditions.
Today's Options® offers PPO plans in New York and Maine. Enroll in a PPO plan now.
By choosing a 2018 Today's Options PPO plan, you'll get:
Affordable coverage – low monthly premiums and cost sharing
Preventive care at no cost - $0 copays for preventive screenings
Freedom to choose providers – see doctors both in and out-of-network
Drug coverage – plans available with comprehensive Medicare Part D prescription drug coverage in most locations
Dental (in some plans), Vision and Hearing
Extra benefits and services not covered by Original Medicare
Plus, a yearly limit on what you could pay out-of-pocket - so you're protected in the event that you have a significant health situation and expense.
Enrollment disclaimer information:
You must continue to pay your Medicare Part B premium. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premium and/or copayments/co-insurance may change on January 1 of each year. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Out-of-network/non-contracted providers are under no obligation to treat Today’s Options PPO members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. You may enroll in the plan only during specific times of the year unless you qualify for a Special Election Period (SEP) or Initial Coverage Election Period (ICEP).