EmblemHealth Advantage Medicare PPO Plans
All the benefits of Original Medicare, plus benefits for in- and out-of-network coverage, with no referrals needed. Prescription drug coverage is not included in this plan.
All the benefits of PPO I, as well as prescription drug coverage.
All the benefits of PPO II, plus coverage for preferred generic drugs through the coverage gap.
PPO High Option
PPO Plans give you the opportunity to choose the doctors you want to see in or out of a plan network, without a referral. The same goes for specialists and hospitals. You don’t even need to have a primary care doctor when you have one of these plans. Your out-of-pocket costs will be even lower for an in-network doctor than an out-of-network one. If having the freedom to see doctors outside a plan network is important to you, a PPO is a great option to consider.
If you select one of these plans, you’ll enjoy:
- Preventive Care — $0 copay for an annual physical
- Low copays for inpatient hospital care
- Low copays for primary care physician office visits
- Prescription drug coverage through the Coverage Gap (PPO III & PPO High Option)
- Dental benefits
- Vision and hearing benefits
- Disease management programs
- No referrals to see doctors and specialists
- Coverage to see doctors in and out of our network (you may pay more to see doctors out of network)
2013 Plan Specific Documents
EmblemHealth Medicare Advantage PPO
Evidence of Coverage
Directories Y0026_122652 CMS Approved 08/12/2011
2013 EmblemHealth HMO and PPO Drug Formulary - Y0026_123210 Accepted 09/09/2012
Low-Income Subsidy Information
Do you get extra help from Medicare to pay for your Medicare prescription drug plan costs? If so, your monthly plan premium will be lower than it would be if you did not get extra help from Medicare. The amount of help you get will determine your total monthly premium as a member of our plan.PPO LIS Premium Summary H5528_123328r Accepted 12/24/2012