I know PPO's are not AgTalk approved and are very unpopular. And I think that is probably correct for a lot of people. There are definitely some disadvantages. But having had one for about 5 years now thought I would pass on my experience as it is "that time of year" again when all the companies are pushing their offerings.

Back when we were evaluating our situation on whether to go with conventional regular Medicare or some other private insurance (PPO, etc), my own conclusion ended up being, if a person was going to regularly be sick and needing medical care conventional Medicare was the way to go. But if a person had pretty good health and did not anticipate nor develop a bad string of medical conditions, the PPO might work out pretty well. I have not changed in that opinion. I think it still holds.

At the time I figured supplemental Medicare policies for drugs and care would run each of us an additional 200 a month or total 400 for both of us. Reading some of the previous discussions on the subject I may have over estimated that amount. Some people claim less. At the time I was just pricing the very best policies so there would basically be no out of pocket costs. Keep that in mind as I give figures. 

Since we were in relatively good health, although me being type II diabetic, We went with a zero cost PPO (Aetna) that showed most of the hospitals in the two towns closest were participants in the plan. The PPO had some additional perks that came with it that Medicare does not cover at no additional cost (some additional dental, eye glasses, hearing aide, etc.). We also decided to open up a savings account specifically to cover the relative high deductible the PPO came with (things like $300 a day for the first 5 days of hospital room coverage). So every month we have 400 dollars that we saved on supplemental Medicare premiums transferred to the savings account automatically. Our reasoning was we would use that money if we had expenses the PPO had deductibles (I think our maximum out of pocket expense is just north of $5,000 a year each) or if we chose out of network care that the policy would only pay a portion.

Fortunately for us we have stayed pretty healthy. Except for my motorcycle/deer accident which I did spend 5 days in the hospital for. 

That savings account now has about $25,000 in it. We didn't actually use it like we said we would. On my deer accident we did have the hospital stay expense as well as a number of other specialist visits, etc. We just paid for those out of our regular accounts with credit card. So I am guessing quite a bit but I would say in the last 5 years we have probably had about 5-6,000 total out of pocket medical expenses that should have came out of that savings. So somewhere around $19,000 savings that awaits anything in the future in the way of medical expense our PPO will not cover entirely.

So for us, as relatively healthy people, It has worked ok. We each get a pair of glasses annually out of it and I have gotten a couple pair of hearing aids included in the PPO. Our medication expense is almost nil although the PPO pays a good portion of what we do have. So I have been satisfied.

Some might say the 200 a month each is over stating what the supplemental drug and insurance policies cost and that could be right. Lets say it was half that at 100 each a month or 200 total. That would have cut our savings down to about 12k and we spent 6k. So still ahead but not by a lot. And we each could have 5k+ a year before we hit our maximum out of pocket costs should our health go down hill fast. So that amount could be eaten up pretty quickly.

I am not pushing PPO's. Just giving two peoples personal experience and how we managed to make sure we had the money to cover uncovered issues.

I think a PPO can be "ok" for a person that:
1. can manage their money and savings adequately
2. is financially stable enough to pay some larger out of pocket costs
3. is pretty healthy to begin with (and somewhat lucky continuing on)
4. local medical facilities are "in the plan" being considered

So far so good with us.

People who it would "not be ok" for:
1. people living paycheck to paycheck with not a lot of wiggle room
2. people who can't manage savings and "save for a rainy day" (if the money is in an account tends to disappear)
3. people with chronic poor health that are going to need a lot of care often
4. not many medical facilities "in the plan" locally so most services would be "outside network" 

Of course no one knows for sure how their health is going to pan out. Wife and I could both get cancer tomorrow and wish we had never heard of a PPO. 

It is all kind of a crap shoot. My personal opinion is that most people are better off with conventional Medicare with supplement policies to fill in the gap. For those in pretty good health and the ability to manage their finances a PPO or some other private insurance "might" turn out ok. 

Time will tell for us. So far so good. Its a crap shoot. Come to think of it, life is a crap shoot.

Just my opinion. Worth exactly what you paid for it.