How to Compare PPO Medicare Supplements

Medicare beneficiaries choosing a Medicare supplement (or "Medigap") will find that comparing policies requires an understanding of individual goals and needs as well as knowledge of available options. In many states, a preferred provider organization (PPO) plan, known as Medicare Select, offers lower Medicare supplement premiums to beneficiaries willing to seek care from providers within the plan's network.

Switching plans to respond to increases in health-care needs and expenses can be costly or even impossible. Choose a plan that is affordable now, yet offers sufficient benefits to accommodate changes in health status later.

Instructions

• 1

  Check with your state insurance commissioner to find out if Medicare Select plans are available in your area. A directory of state insurance offices can be found in the Resources section.

  Beneficiaries in states that do not allow Medicare Select plans are not able to choose a Medicare Supplement PPO. Some states have a limited number of Medicare Supplement PPOs serving specific areas within the state.

• 2

  Set your goals and expectations for a Medicare supplement. Before comparing specific Medicare supplement PPOs, consider the following questions as a guide toward finding the best policy at the best price:

  1. How much of a monthly premium can you afford?
  2. What benefits do you expect to need?
  3. Do you have funds to cover a pre-existing-condition exclusion or waiting period? If so, for how long?
  4. How important is it to be able to continue seeing your current physicians?

• 3

  Find the type of plan that best suits your needs. The federal Medicare program regulates Medigap and has created 12 types of plans labeled A through L that private insurers can offer. Medicare Select plans will offer the same benefits as traditional Medigap policies of the same type. Plan A is known as "basic" Medigap. The most popular plan type is Plan F.

  The Medigap comparison tool in the Resources section contains a listing of the benefits offered by each type of Medicare supplement.

• 4

  Identify Medicare supplement PPOs in your area. Using the Medigap comparison tool in the Resources section, enter geographic area information and select the plan type that best suits your needs. The website provides an additional option to show only Medicare Select plans.

• 5

  Evaluate the premiums, provider network and any pre-existing-condition exclusions and/or coverage waiting periods for each plan.

  Each state is responsible for regulating its insurers and maintaining quality data. Consult the state insurance office contacts in the Resources section or contact Medicare directly by calling 1-800-MEDICARE (1-800-633-4227) if you need further assistance in comparing Medicare supplement PPOs.