Amerigroup PPO

A Medicare Advantage PPO plan is one type of Medicare Advantage plan. Medicare Advantage plans bundle all the benefits of Medicare Part A and Medicare Part B into one convenient plan. Plus, they often include extras, such as coverage for prescription drugs, vision, dental, and hearing aids.

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What Is an Amerigroup Medicare Advantage PPO Plan?

A Medicare Advantage PPO plan is a Part C plan that works like a Preferred Provider Organization (PPO) plan. Amerigroup’s Medicare Advantage PPO plan gives you the flexibility to work with any doctor or specialist (in or out of network), no referrals needed. If you choose to see a provider outside your plan, your costs may be higher.

The Difference between a PPO and an HMO

With a Medicare Advantage HMO, you may only see doctors or specialists who are in network. Also, in an HMO, you must get a referral from your primary care physician (PCP) to see a specialist, which you do not need in a PPO.

People with Medicare and Medicaid may enroll in Medicare Advantage Special Needs Plans (SNPs). SNPs are Medicare Advantage HMO plans for people with limited incomes or certain conditions or diseases.

What Amerigroup Medicare Advantage PPO Plans Cover

All Amerigroup Medicare Advantage plans include benefits similar to our Medicare Advantage HMO plans, including:

Preventive Services

Many preventive services, such as regular check-ups, tests, shots and screenings, are included at no extra cost.

Part D (Prescription Drug Coverage)

Original Medicare doesn’t cover prescriptions and medications that most people need. Most Medicare Advantage plans include Part D coverage.

Over-the-Counter Items
Some Medicare Advantage plans cover non-prescription over-the-counter (OTC) medicines and health-related items, such as pain relievers, cold medicine, and other first-aid care, at specific retailers.

Vision and Dental Coverage
Some Medicare Advantage Plans (Part C) may include vision and/or dental benefits that Medicare doesn’t cover. You may also add an optional supplemental benefit package for more coverage than what is included in a Medicare Advantage plan.

Hearing Aids
Some Medicare Advantage PPO plans cover routine hearing tests, hearing aid fittings, and hearing aids. Costs outside the network may be higher.

SilverSneakers®
As part of your Anthem MediBlue PPO plan, you may also have access to SilverSneakers®, a popular fitness program for adults age 65+.

Costs Of An Amerigroup Amerivantage Medicare Advantage PPO Plan

Since you may decide to receive care in-network or out-of-network with an Amerigroup Medicare Advantage PPO, some costs, such as deductibles, coinsurance, or copays may vary within the plan. Here are some important points to keep in mind.

Typical Costs of an Amerigroup Medicare Advantage PPO:

Deductibles

Some plans have $0 deductibles for medical costs. Your deductibles for out-of-network care may be higher than for in-network care.

Copayments or Coinsurance

The amount of copayments or coinsurance you pay when you visit a doctor or specialist varies, depending on whether they are in-network or out-of-network.

You’ll pay the lowest cost when visiting in-network providers. But you have the option to pay a little more when you want to see an out-of-network provider.

Is an Amerigroup Medicare Advantage PPO plan right for you?

A Medicare Advantage PPO plan may be right for you if:

You want the freedom to choose out-of-network doctors or care facilities.

You may travel out of your plans service area and want to use services out of network other than emergency care, urgent care and/or dialysis.

You do not mind paying more sometimes to see an out-of-network doctor

Healthcare App for Amerigroup Members

Let’s make healthy happen – and make it easier, too. Download the mobile app and access tools to help you take charge of your plan. Available for iOS and Android devices.

Learn more about the mobile app.