Preferred Provider Organization (PPO) Plans are more costly because they offer a lot of flexibility by allowing the beneficiary to go outside the network of providers to receive care. They also do not have to select a primary care physician or get a referral to see a specialist.
Some of the extra coverage and benefits that a PPO Plan can provide includes:
- Dental, vision, and hearing coverage
- Prescription drug coverage
- Transportation to doctor visits
- Adult daycare services
- Fitness memberships
- Nutrition programs
- Wellness programs
To first be eligible for a PPO Plan, you must live within the plan’s service area. You must also be enrolled in Original Medicare. You cannot drop your Original Medicare coverage, otherwise, you will not be eligible for a PPO Plan.
You can enroll in a PPO Plan during specific enrollment periods:
- Initial Enrollment Period: The Initial Enrollment Period (IEP) is a seven-month period that starts three months before your 65th birthday month and ends three months after.
- Annual Election Period: The Annual Election Period (AEP) lets Medicare beneficiaries change their Medicare coverage from October 15 to December 7.
- Medicare Advantage Open Enrollment Period: The Medicare Advantage Open Enrollment Period starts from January 1 and ends March 31. If you’re already enrolled in a Medicare Advantage Plan, you can use this period to switch to a different MA/MAPD Plan.
- Special Enrollment Period: The Special Enrollment Period (SEP) gives you the opportunity to sign up for Medicare or switch to a new Medicare plan, but only if you are in a special circumstance.