PPO stands for Preferred Provider Organization. With a PPO plan, you are assigned a network of healthcare service providers. You will pay much less out-of-pocket when you use doctors, hospitals, and other service providers within your designated network.
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If you wish to be seen by someone outside your network for a covered service, you will not be denied coverage. Provided they work with Medicare, you may see your preferred medical professional, regardless of network. This will likely cost you more money out-of-pocket, but the flexibility of this plan makes PPO an empowering option.
While it may be ideal to get your healthcare from the physician or professional of your choice, it is still wise to familiarize yourself with your in-network options. When possible, using in-network care providers can save a lot of money. Note that with a PPO plan, you will always be covered for emergency and urgent care, regardless of network. You will not need to choose a primary care provider to receive coverage with a PPO plan. You will also not have to get a referral before seeing a specialist, though it could save you additional expenses.
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We are not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.
