Anthem Medicare Advantage PPO
What is a PPO and how does it work?
PPO stands for Preferred Provider Organization. A PPO is structured to help you save on costs through low monthly premiums and low copayments while providing both in-network and out-of-network coverage. Once you’re enrolled, you’ll receive a directory of providers that participate in our network. If you choose to see a doctor or hospital that is not part of our network, you may do so, however you would be required to pay additional out-of-pocket costs instead of just the minimal copayment (except in the case of emergency or urgent care.)
Got a great doctor?
You can keep it that way. We know how important it is to find (and stay) with a doctor you trust. That’s what’s great about a PPO – you have the freedom to choose any doctor whether they’re in or out-of our network. And, if you’re in the market for a new doctor, you’ll be happy to know that you’ll find thousands of extremely qualified physicians with established practices and high levels of credentials right in our network.
Low copayments for doctor visits, $0 copayment for Medicare-covered preventive services
A copayment is your portion of the cost that you make each time you visit a doctor or other health care provider. The good news is that if you are seeing a doctor for a preventive service such as routine physical exams, immunizations, screenings, etc., no copayment is required for these services. (If you receive other benefits during the same doctor visit, you may pay a copayment for those services.)
Part D (Prescription Drug) Coverage
As a member of an Anthem Medicare Advantage PPO, you are automatically enrolled in Medicare Part D, Medicare’s prescription drug coverage. You don’t need to enroll in a separate Part D plan.
What are the advantages of an Anthem Medicare Advantage PPO Plan?
The great advantage of an Anthem PPO plan is that the low premiums provide significant savings while you have the flexibility of seeking care either within the network at a modest cost to you or out-of network at an additional cost. It’s your choice.
Another advantage is that you get access to hundreds of preventive and wellness programs, discounts on products and services and tools and kits that can help educate and guide you about ways to live a healthier lifestyle. These are extras that original Medicare doesn’t offer.
What are the costs?
You’ll be responsible for a low or no monthly premium. Also, whenever you visit a doctor (except for most Medicare-covered preventive services,) you’ll be asked to pay a small copayment at the time of service. You must also continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third-party.
Who is eligible?
You are eligible for an Anthem Medicare Advantage PPO plan if you are entitled to Medicare Part A and enrolled in Medicare Part B and live in the service area (counties and states that have access to Anthem coverage)
. However, individuals with end-stage Renal Disease are generally not eligible to enroll in a Medicare Advantage plan.
How do I choose an Anthem PPO Plan?
The best way to choose is to compare coverage and rates. You can do this by clicking here
CMS Approved Date 09/2008, Material Identification M0013_09_041
Last Updated 09/2008