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


2023 Medicare PPO Map

Flex | Flex Rx PPO

Monthly Premium1

Flex: $0*

Flex Rx: $39.40

In-Network

Out-of-Network

Primary Care Physician

$0

Primary Care Physician

$40

Doctor on Demand

$0

Doctor on Demand

$0

Specialist Copayment

$40

Specialist Copayment

30%

Routine Annual Physical Exam Copayment

$0

Routine Annual Physical Exam Copayment

30%

Urgent Care Copayment

$60 worldwide coverage

Urgent Care Copayment

$60 worldwide coverage

Emergency Room Copayment1

$90 worldwide coverage

Emergency Room Copayment1

$90 worldwide coverage

Ambulance

$255

Ambulance

$255

Outpatient Surgery

$250-$325

Outpatient Surgery

30%

Physical Therapy

$40

Physical Therapy

$60

Inpatient Hospitalization

Days 1-6: $310 per day

Inpatient Hospitalization

30%

Dental reimbursement for all dental services:
Routine Cleaning/Restorative/Dentures (not for whitening)

$450 reimbursement

Vision: Annual Routine Eye Exam

$20

Vision: Annual Routine Eye Exam

30%

Frames/Lenses (per year)

$175 reimbursement

Hearing Care Solutions Hearing Aid Benefit

$599 or $899

Over-the-counter Benefit

$25 / quarter

Over-the-counter Benefit

Not available

Senior Fit Included

Yes

CDPHP Life Points® Rewards

Earn up to $125

Lab Services

$0 or $5

Lab Services

30%

X-rays

$35

X-rays

$40

Advanced Imaging Studies (CT, MRI, etc.)

$135

Advanced Imaging Studies (CT, MRI, etc.)

30%

OOP Max

$6,100

OOP Max (Combined)

$10,000

Plan Documents

Evidence of Coverage (EOC) and Summary of Benefits (SOB)

*Does not include Rx


Disclaimer:

  1. You must continue to pay your Medicare Part B premium; You may qualify for lower premiums with EPIC or Low Income Subsidy

  2. Copayment waived if admitted to the hospital within 24 hours for the same diagnosis.