Amerus Ultimate PPO vs Ultimate 5K PPO: the key differences

Compare two Amerus PPO options using their 2026 documents, including office visits, gross deductible, gap benefits and out-of-network care.

Do not compare the brochure names alone

Ultimate PPO and Ultimate 5K PPO both use a PPO design, but their benefits are not identical. The Ultimate 5K guide shows $40 primary care and $80 specialist in-network copays with a $5,000 individual deductible for services subject to it. The Ultimate PPO SBC describes a different gross deductible and an integrated gap offset for eligible amounts.

Put the same service rows side by side

Compare primary care, specialist, imaging, outpatient surgery, hospitalization and prescriptions on the exact 2026 documents. Check whether the deductible applies first, whether a copay is fixed, and whether a separate gap benefit can reimburse part of a charge. Both plans have out-of-network terms that may expose you to balance bills.

Use the approved rate

Published household rates help narrow a shortlist, but medical underwriting, state availability and final first-month charges still require review. Add twelve approved premiums to a routine-care and a costly-care scenario. Ask for each plan’s current SBC and guide before choosing, and keep the existing plan until replacement coverage is confirmed.

Make the comparison useful

When comparing the two Amerus PPO options, use the same household and age, and keep brochure prices separate from an approved offer. Note which charges are fixed copays, which first meet a deductible, and whether the integrated gap benefit or separate supplement affects the result. The lower monthly price can still lead to higher total cost under some use patterns.

Sources

Frequently asked questions

Are both Amerus PPO plans the same except for deductible?

No. Copays, gap-benefit structure, deductible treatment and other terms differ. Compare the linked documents row by row.

Educational information reviewed October 28, 2026. Product terms, rates, network access, state availability and underwriting can change. The current official plan documents and written eligibility decision control. Prestige is an independent insurance agency, not the insurer.

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