Could a Medicare Advantage PPO plan be right for you?
PPO plans offer coverage for both in-network and out-of network providers. So if you spend extended periods of time away from home, a PPO plan might be a good fit. You also won't need to designate a primary care physican (PCP) with these plans.
Check out the Medicare Advantage PPO plans listed below to see which one may best fit your needs.
Compare Plans
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Vital Rx PPO
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Monthly Premium*
$0
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In-Network
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Out-of-Network
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Primary Care Physician
$0
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Primary Care Physician
$50
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Doctor on Demand
$0
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Doctor on Demand
$0
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Specialist Copayment
$45
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Specialist Copayment
40%
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Routine Annual Physical Exam Copayment
$0
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Routine Annual Physical Exam Copayment
40%
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Urgent Care Copayment
$55 worldwide coverage
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Urgent Care Copayment
$55 worldwide coverage
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Emergency Room Copayment1
$120 worldwide coverage
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Emergency Room Copayment1
$120 worldwide coverage
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Ambulance
$265
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Ambulance
$265
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Outpatient Surgery
$335-$360
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Outpatient Surgery
40%
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Physical Therapy
$40
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Physical Therapy
40%
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Inpatient Hospitalization
Days 1-5: $500 per day
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Inpatient Hospitalization
40%
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Dental Allowance on a prepaid Benefits Mastercard to use at any dentist in the U.S. for all dental services, routine cleaning/restorative/dentures (not to be used for teeth whitening):
$725
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Vision: Annual Routine Eye Exam
$20
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Vision: Annual Routine Eye Exam
40%
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Frames/Lenses on a prepaid Benefits Mastercard (per year)
$125
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Hearing Care Solutions Hearing Aid Benefit (per ear)
$599 or $899
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Over-the-counter Benefit
Not available
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Over-the-counter Benefit
Not available
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Senior Fit Included
Yes
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CDPHP Life Points® Rewards
Earn up to $125
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Lab Services
$0 or $5
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Lab Services
40%
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X-rays
$10
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X-rays
40%
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Advanced Imaging Studies (CT, MRI, etc.)
$175
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Advanced Imaging Studies (CT, MRI, etc.)
40%
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OOP Max
$6,750
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OOP Max (Combined)
$10,100
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Plan Documents
Evidence of Coverage (EOC) & Summary of Benefits (SOB) Information
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View a side-by-side comparison
Medicare Advantage Plan Options
Medicare Advantage Plan Options – Western NY
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*You must continue to pay your Medicare Part B premium; You may qualify for lower premiums with EPIC or Low Income Subsidy.
Disclaimer:
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Copayment waived if admitted to the hospital within 24 hours for the same diagnosis.