What Is the Blue Medicare Advantage PPO Plan?


Quick Answer

The Blue Medicare Advantage PPO plan is a private insurance product offered by several Blue Cross Blue Shield affiliates in more than 3,200 counties nationwide as of 2015, notes Care Bulletin. Medicare Advantage plans, also known as Medicare Part C, are offered by private insurance companies, and Preferred Provider Organization plans cost less to beneficiaries who receive services from health care providers who are part of the PPO network, explains Medicare.gov.

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Full Answer

Blue Cross Blue Shield Medicare Advantage plans provide Original Medicare coverage, prescription drug coverage, and additional benefits and services, according to BlueCross BlueShield of Illinois. The PPO version of the plan is only available in certain counties.

A PPO plan provides more flexibility to enrollees to visit health care providers outside of the plan's network, though these services cost more than in-network providers, explains the Henry J. Kaiser Family Foundation. In a PPO plan, the beneficiary does not need to choose a primary care provider, according to Medicare.gov. Beneficiaries usually do not need a referral to see specialists.

In 2015, of the 2.6 million Americans enrolled in a Blue Cross Blue Shield affiliate's Medicare Advantage plan, 48 percent are enrolled in a local or regional PPO plan, notes the Henry J. Kaiser Family Foundation.

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