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Medicare PPO Plans ; You can get your Medicare benefits through Original Medicare, or a Medicare Advantage Plan (like an HMO, PPO, PFFS).
If you have Original Medicare, the government pays for Medicare benefits when you get them. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare.
Medicare pays these companies to cover your Medicare benefits.
If you join a Medicare Advantage Plan, the plan will provide all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage.
This is different than a Medicare Supplement Insurance (Medigap) policy.
PPO plans do not require beneficiaries to a choose a primary care physician, use in-network providers, or require a referral to see a specialist.
In a PPO, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network (thus, the use of the term “Preferred”).
You usually pay more if you use doctors, hospitals, and providers outside of the network. PPO plans generally include prescription drug coverage through a Medicare Advantage Prescription Drug plan (MAPD).