Plans & Coverage
Medicare PPO Plans
A PPO (Preferred Provider Organization) is a Medicare Advantage plan that lets you see out-of-network providers at a higher cost and usually skips referrals. PPOs suit people who travel, split time between states, or simply want maximum flexibility while still getting Advantage extras like dental, vision, and an out-of-pocket cap.
How a PPO works
You get the lowest costs by staying in-network, but unlike an HMO you can also see out-of-network providers who accept the plan — you just pay more. You generally don't need referrals to see specialists. That flexibility is the whole reason to choose a PPO over an HMO.
Is a PPO right for you?
If you spend winters away, see specialists across the CO/UT region, travel to see family, or simply want freedom without referrals, a PPO's flexibility can be well worth the slightly higher premium and copays. For clients who split time between Grand Junction, Moab, and elsewhere, PPOs are often the better fit.
PPO trade-offs
PPOs usually carry higher premiums or copays than HMOs, and 'out-of-network' still means higher cost-sharing and a separate, higher out-of-pocket maximum. It's flexibility, not a blank check — we make sure the extra cost buys you flexibility you'll actually use.
What's your ZIP code?
We start local — plan availability is set by your county.
How old are you?
This tells us which coverage window you're in.
Which best describes you?
Pick one — you can change this anytime.
How often do you see doctors?
Helps us weigh networks vs. freedom.
Do you take prescriptions?
We match your drugs to the lowest-cost plan.
No cost, no pressure. We do not offer every plan available in your area — for all options visit Medicare.gov or call 1-800-MEDICARE.
Questions, answered
Do PPO plans cost more than HMOs?
Often slightly more in premium or copays, in exchange for out-of-network flexibility and no referrals. The right trade-off depends on how and where you use care — we compare both for your situation.
Can I use any doctor with a Medicare Advantage PPO?
You can see out-of-network providers who accept the plan, but at a higher cost. Staying in-network is cheapest. We check that your main doctors are in-network before you choose.
Do I need referrals on a PPO?
Usually no — that's one of the main advantages of a PPO over an HMO. You can go straight to a specialist, in or out of network.
Official Medicare sources
We point you to the federal sources so you can verify everything. For current-year figures and to compare the plans available in your area:
- Medicare.gov — the official U.S. government site for Medicare costs, coverage, and rules.
- Medicare Plan Compare — the official tool to compare Medicare Advantage and Part D plans by ZIP.
- Social Security (ssa.gov) — enroll in Medicare Parts A & B and check your eligibility.
- CMS.gov — Centers for Medicare & Medicaid Services, which runs the program.
Education and estimates only — confirm current figures on Medicare.gov before enrolling. We do not offer every plan available in your area.
Talk to a local Medicare advisor
Free, no pressure — we compare your options for you.
Last updated . Maintained by the Medicare On Main Data Desk · reviewed by Brian Penner, Independent Medicare advisor (NPN 16493717).