Who Is Eligible to Enroll in a GHI PPO Medicare Advantage Plan?


Quick Answer

Seniors who meet the following criteria are eligible to enroll in PPO Medicare Advantage through Group Health Incorporated. They must be 65, qualify for Medicare Part A,.and be enrolled in Medicare Part B while maintaining Part A coverage, states EmblemHealth. They must also be residents of New York state.

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Full Answer

A senior is eligible for GHI PPO Medicare Advantage regardless of the pre-existing conditions he may have. The one exception to this is end-stage renal disease. Individuals who have end-stage renal disease are likely ineligible for a PPO Medicare Advantage plan through GHI, according to EmblemHealth.

GHI is a division of EmblemHealth, a large insurance provider and administrator. Individuals can enroll for PPO Medicare Advantage through the EmblemHealth website or schedule a home visit with a representative who can help him explore coverage options, as explained by EmblemHealth.

Medicare Advantage is insurance seniors can purchase to supplement Medicare Parts A and B, states Medicare.gov. Medicare Advantage is also known as Medicare Part C. A PPO or preferred provider organization is one of the several types of Medicare Advantage from which seniors can chose. Seniors covered by a PPO have a list of physicians who are considered in network. Visiting an in-network doctor is less expensive that visiting a doctor who is out of network. One of the benefits of a PPO plan is that individuals are not required to get a referral from a primary care physician prior to visiting a specialist.

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