Best Medicare Advantage plan for seeing doctors outside a network in Penobscot County, Maine

Why this plan

HumanaChoice Giveback H5216-138 (PPO) is a PPO, so it pays for covered care from doctors in and out of its network. It charges no premium, and the most you'd pay for covered care in and out of network together is $7,750 a year: the lowest worst case of the 5 PPOs here. The next is HumanaChoice H5216-175 (PPO), at $10,000 a year at most (no premium, a $10,000 limit).

For care in its network alone, the limit is $6,500.

What it gives up

Nothing we can measure: its premium and out-of-pocket limit are no higher than most plans' here, and its star rating isn't below average.

Where else it does well

• Its out-of-pocket limit, $6,500, is among the lowest here; the middle plan's is $7,550.
• It also gives back $61 a month of your Part B premium.

Who it suits

A PPO suits you if a doctor you want to keep isn't in a plan's network, or you spend part of the year in another state. You pay more out of network, and a doctor outside it can decline to bill the plan, but the plan still pays its share. An HMO usually pays nothing outside its network except in an emergency.

The next best for seeing doctors outside a network

Before you choose

• Check your doctors and hospitals. Most Medicare Advantage plans pay only, or mostly, for care in their own network. Ask the plan, or your doctor's office, before you join.
• Price your prescriptions. What your drugs cost can differ by hundreds of dollars a year between plans and outweigh any premium difference. Add them in our plan list to see your own costs.
• Read the plan's own documents. We take every figure from what the plan filed with Medicare, but its Evidence of Coverage is the final word on what it pays.
• Get free advice if you want it. Your State Health Insurance Assistance Program (SHIP) gives free, unbiased help choosing a plan.

How we picked

Among PPO plans, which pay for covered care from doctors outside their network, the one whose worst year costs least: twelve months of premiums plus its yearly limit on what you pay for in- and out-of-network care together. Where several tie, we look next at the highest star rating, then the largest Part B giveback, then the lowest premium, then the lowest out-of-pocket limit for in-network care, then the lowest copay to see a primary care doctor. Plans that still tie are listed by name.

We compare the 15 Medicare Advantage plans with drug coverage that anyone with Medicare in Penobscot County can join. Special needs plans and PACE, which are only for people who qualify, aren't included; you'll find them on the Penobscot County page. No plan pays to be picked.