Consider what is most important to you in a health plan: cost, availability and location of providers, or freedom to see any doctor. If you like the physician you are currently seeing, check to see if he or she is a provider in the plan that you are considering. If you or a dependent has special medical needs, check that the plan you are considering has adequate medical services and providers for that specialty.

Yes, as long as the physician that you choose accepts your managed care plan. You may verify that the doctor you choose accepts your insurance by calling your doctor's office, visiting the physician’s profile on this web site, calling AccessMD or calling your doctor’s office.

A special arrangement between an insurer and hospitals, physicians and other health care professionals to pay for health care services, resulting in savings for the insured. PPO coverage does not require you to use a PPO doctor. approach to health care utilizing the Primary Care Physician (PCP) concept. HMOs provide preventive care, such as routine physicals, education, and early intervention to decrease occurrence of disease.

Your health plan's HMO (Blue Cross, Blue Shield, Health Net, PacifiCare, or San Francisco Health Plan) has contracted with the Physicians Integrated Medical Group and its integrated network of medical providers to furnish and coordinate all of your health care needs through your Primary Care Physician (PCP). The Primary Care Physician whom you have chosen determines your medical group affiliation.

Request a list of participating doctors from your insurance company if you do not have an existing doctor or you need to select a new one. Talk to friends, co-workers, or neighbors about their doctors. Contact the medical society and hospitals for a listing of physicians accepting new patients in your area. Find out if any of these doctors participate with your insurance company. Call the physician's offices to verify that the physician will accept you as a patient.

Before you make a selection, carefully compare the plans available in your area. Think about what is most important to you in a health plan: low cost; availability of a specific physician, clinic, or hospital; freedom to see any physician you want; or convenient location of facilities. Be prepared to make some tradeoffs. If you like the physician you are currently seeing, check to see if he or she is a provider in the plan you are considering.

You may change MO HealthNet managed care health plans for any reason during the first 90 days after you become a MO HealthNet managed care health plan member. Call the MO HealthNet Managed Care Enrollment Helpline at 1-800-348-6627. You may be able to change MO HealthNet managed care health plans after 90 days.

You should receive a letter in the mail with open enrollment dates. You may also call the MO HealthNet Managed Care Enrollment Helpline at 1-800-348-6627 or the MO HealthNet Participant Services Unit at 1-800-392-2161 or 573/751-6527.

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In the PPO plan, you have in-network and out-of-network benefits. Your benefits are richer (your cost saving are more) for using doctors and medical facilities that are in-network, but you have coverage (benefits) if you use doctors and medical facilities that are out-of-network. You do have to meet a deductible before your benefits begin, except for your doctor visit co-payments. In the HMO-Select plan, you must choose a Primary Care Physician, who will then refer all your specialty care.

Health insurance companies generally offer a variety of health insurance plans and options. A PPO is generally a health insurance plan which provides increased benefits when you go to participating panel medical providers. An HMO generally requires that the plan member goes to plan providers and pays little or nothing for the visit. Generally visits to no-plan providers are not permitted except in emergencies.

Both a Preferred Provider Organization (PPO) plan and a Health Maintenance Organization (HMO) plan use provider networks. Medical providers in both types of plan networks have contracted to provide their services and facilities to plan participants at reduced costs. Participants of a PPO plan have complete freedom in choosing physicians and medical facilities whenever in need of care.

A qualified insurance agent can quickly gather all of this information, saving you a lot of time and effort.

You have a right to change the primary care provider in your MO HealthNet managed care health plan. You can change at least two times each year. Some MO HealthNet managed care health plans may allow more. Children in state custody may change their primary care provider as often as necessary. To change your primary care provider or to find out more about your MO HealthNet managed care health plan, call the membership services number on your managed care health insurance card.

No. All BCBSNM Medicare Supplement plans give you the freedom to use any physician and any hospital you desire. You don't need a referral from one doctor to see another.

Yes. We have a listing of many physicians, hospitals and other providers who are part of our network. Our network includes providers at Marshfield Clinic and many other clinics and independent providers in our service area. In general, you will only have insurance coverage if you see providers affiliated with Security Health Plan.

The primary difference is that HMOs limit your non-emergency health care coverage to a limited network of physicians and hospitals. PPO plans insure covered services delivered by any licensed physician or hospital, though a PPO plan will offer improved benefits if you use physicians and hospitals participating in the PPO's preferred network. PPO networks are normally much larger than HMO networks, though HMOs provide higher benefit levels.

With traditional (indemnity) insurance, you can select any doctor or hospital at the time service is needed. You do not need a referral to see a doctor. Under managed care, doctors, hospitals and other health care providers contract with the health plan to form networks that deliver health care services. Normally, you will select providers from within those networks to get the maximum coverage available through the health plan.