Medicare Advantage PPO Plans

A Medicare Preferred Provider Organization (PPO) plan is a type of Medicare Advantage plan a private insurance company offers. PPO plans include a network of doctors, hospitals, and other health care providers. If you use this network for health care, you save on Medicare costs.

What Are the Benefits of a Medicare Advantage PPO Plan?

A Medicare Advantage plan offers more benefits than Original Medicare with minimal to no extra premium. These advantages can be:

  • Fitness memberships
  • Over-the-counter drugs
  • Adult day-care services
  • Transportation to doctor’s offices
  • Nutrition and wellness programs
  • And more

Whether you are eligible for some benefits depends on your area and plan providers. However, there are unique upsides to having a PPO Advantage plan. First, you do not need a referral to visit a specialist, and you do not have to choose a primary care physician. Next, most PPO Advantage plans cover prescription drugs. To see which benefits are available in your area, you should talk to a licensed Medicare insurance specialist.

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When Can You Enroll in Medicare Advantage?

There are set times when you can enroll in a Part C plan:

Initial Coverage Election Period (ICEP)

ICEP is a seven-month period that is your first opportunity to choose a Medicare health plan. It starts three months before the month you turn 65 and ends three months after the month you turn 65. If you are under 65 and you receive Social Security disability, you are eligible for Medicare in the 25th month after you begin receiving your Social Security benefits.  

Annual Election Period (AEP)

Also known as open enrollment, the AEP is October 15 through December 7 each year. Once January hits, coverage for your selected Medicare Advantage plan will begin. During this time, you may also add, change, or drop current coverage.   

Medicare Advantage Open Enrollment Period

During this period, you can switch from one Medicare Advantage plan to another. Or, you can end it to return to Original Medicare. 

Special Election Period

Many factors can stimulate a special election period and they are unique to an individual. It’s best to speak with a licensed Medicare insurance agent to find out whether you qualify for a special election period. However, there are a few common situations, like if you move outside your Advantage plan’s service area, move into a nursing home, or qualify for additional aid, you could be eligible for this special election period. You can institute changes to your Medicare Advantage plan during this period or go back to Original Medicare.

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If you have questions or you need to change your Medicare coverage, call 800-515-4031 to reach our Texas office.