Note: This chart is only meant to quickly help you identify the differences between the HIP plans we currently offer. For a comprehensive and detailed listing of medical services that are covered, please refer to the summary of benefits provided online. Please follow this link in order to view the chart. Don't sue us! Fractured Atlas is not an insurance company. We're also not lawyers, brokers, agents, doctors, or anyone else qualified to give professional advice.

Most HMOs require you to select a specific doctor as your primary care physician, or PCP. This doctor is supposed to be your first "port-of-call" for most any medical condition, although exceptions are typically made for emergencies. As such, he or she will end up providing most of your medical care. See similar questions...

In an HMO, the insured's choice of doctors and hospitals is limited to those that have agreements with the HMO to provide care. Exceptions are made in emergencies and when medically necessary. In contrast, an insured in a PPO can use doctors who are not part of the plan and still receive some coverage. In such cases, the insured will pay a larger portion of the bill him/herself and will have to fill out some claim forms. See similar questions...

No, you and your dependents must enroll in the same medical plan. (Exception: If you and your spouse are both employed full-time by Enterprise, each may enroll separately and into different plans.) See similar questions...

PPOs, Preferred Provider Organizations, are groups of hospitals and/or physicians who, directly or through a third party, develop contractual arrangements with payers to provide a specified set of health care services under defined financial arrangements. EPOs, Exclusive Provider Organizations, are similar to PPOs in their organization and purpose. Unlike PPOs, however, EPOs limit their beneficiaries to participating providers for their health care services. See similar questions...

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. See similar questions...

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. See similar questions...

This plan is not an HMO or PPO. There are no restrictions on which doctors you may see. You have the freedom to select the doctors and hospitals of your choice. See similar questions...

EPO and PPO members are not required to select a PCP to coordinate their care but we recommend that you establish a relationship with your physician. All preventive services must be received from an affiliated, in-network provider. See similar questions...

HMO is a Health Maintenance Organization, which requires you to select a primary care doctor who helps you manage your health care needs. A PPO is a Preferred Provider Organization, which allows you to select any doctor within the network at the time of service without having to first identify a specific primary care provider. It allows for greater freedom of choice. See similar questions...

Health Maintenance Organizations (HMO's) require a patient to select a primary care physician to coordinate his or her care. Most HMO's provide care through a network of hospitals, physicians and other medical professionals that, as a patient, you must use to be covered for that service. Preferred Provider Organizations (PPO's) provide care through a network of hospitals, physicians and other medical professionals. See similar questions...

HMO/PPO insurance company sets a cap on fees that can be charged for procedures. By joining a HMO/PPO group, the dentist agrees to abide by these restrictions, which enables the company and the patient to know the predetermined costs. Because fees are controlled, it is possible that a participating dentist may need to control your treatment options, the materials used and the time that can be spent with you during treatment, none of which can be construed as beneficial to you, the patient. See similar questions...

participate in the Health Net of the Northeast network. Out of network services or expenses will not be covered. The HMO plan requires co-pays at the time of service. The United Healthcare PPO plan covers both in network and out of network physicians and facilities. The PPO plan uses deductibles. The deductible is lower and the insurance reimbursement is higher when you use in network providers. See similar questions...

By assembling a network of providers who agree to provide services at a discount (PPO) or by requiring you get all of your services from a specific provider, with an emphasis on preventative care (HMO), the hope is to provide you the best possible care at the lowest possible costs. A downside is such benefits and discounts require a great deal of control over your health care options by the PPO or HMO, and not all the limitations are popular or convenient. See similar questions...

HMO stands for Health Maintenance Organization. An HMO is a group that contracts with medical facilities, physicians, employers and occasionally individual patients to provide medical care to a group of individuals. An HMO patient must select a Primary Care Physician (PCP) contracted with their HMO. The patient’s PCP is responsible for referring the patient to any and all additional providers (specialty care physicians, hospital, etc). See similar questions...

PPO stands for Preferred Provider Organization which consists of a group of health care professionals who provide care to a specified group of patients. Patients in a PPO typically have greater choice in selecting care providers than they would have in an HMO. Unlike most HMOs, the patient often has the right to obtain services outside of the list of providers, but the patient may pay a higher fee. See similar questions...

PPO members are not required to stay within the PPO network, but there is usually a strong financial incentive to do so. See similar questions...