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Best Medicare Advantage plan for seeing doctors outside a network in Suffolk County, Massachusetts
2026 plans with drug coverage, open to anyone with Medicare here. Other years: 2026 · 2027
Our pick for seeing doctors outside a network
Mass General Brigham Advantage Signature (PPO)
Mass General Brigham Health Plan · H9485-003-000 · PPO
The most a year can cost, in or out of network $3,900 a year at most
- Premium
- $325/mo
- Out-of-pocket limit
- $0
- Part B giveback
- None
- Star rating
- 4★
Why this plan
Mass General Brigham Advantage Signature (PPO) is a PPO, so it pays for covered care from doctors in and out of its network. Its premiums, $3,900 a year, are all it charges: it files no cost sharing for covered care in or out of network (a $0 limit), so $3,900 is the most a year costs: the lowest worst case of the 14 PPOs here. The next is HumanaChoice H5216-249 (PPO), at $7,000 a year at most (no premium, a $7,000 limit).
A $0 out-of-pocket limit is rare: before you rely on it, check the plan's Evidence of Coverage, which is the final word on what you pay.
What it gives up
- Its premium, $325 a month, is higher than most plans here; the middle plan charges $59.50 a month.
Where else it does well
- Its out-of-pocket limit, $0, is among the lowest here; the middle plan's is $5,350.
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
| Plan | The most a year can cost, in or out of network | Premium | Out-of-pocket limit | Stars |
|---|---|---|---|---|
| HumanaChoice H5216-249 (PPO) Humana · PPO | $7,000 a year at most | $0/mo | $6,750 | 3.5★ |
| Mass General Brigham Advantage Premier (PPO) Mass General Brigham Health Plan · PPO | $7,250 a year at most | $150/mo | $3,150 | 4★ |
| HumanaChoice Giveback H7617-046 (PPO) Humana · PPO | $7,750 a year at most | $0/mo | $6,500 | 4.5★ |
| HumanaChoice Giveback H5216-138 (PPO) Humana · PPO | $7,750 a year at most | $0/mo | $6,500 | 3.5★ |
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 30 Medicare Advantage plans with drug coverage that anyone with Medicare in Suffolk County can join. Special needs plans and PACE, which are only for people who qualify, aren't included; you'll find them on the Suffolk County page. No plan pays to be picked.
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