PPO | Preferred Provider Organization

PPO plans usually offer Medicare Part D prescription drug benefits. Part D is Medicare’s prescription drug benefit.

If you are enrolled in a PPO MA plan, and you wish to have Medicare drug coverage you must get it from that plan. Some PPO’s offer additional benefits such as dental and vision care, but those may come at an extra cost. In order to have the lowest costs with your PPO plan you must use providers within the PPO’s network unless you find yourself in urgent care or an emergency situation.

PPOs are limited in how much they can charge you for copays, however for some kinds of care they can and may charge more than Original Medicare. This care includes home care and care in skilled nursing facilities. Plans must have an annual out-of-pocket limit on how much you pay, but PPOs have two different out-of-pocket limits, one for in-network care and one for out-of-network care. These limits may be high, but they can protect you from excessive costs if you need extra care or expensive treatments.