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. See similar questions...

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...

A Health Maintenance Organization (HMO) only provides care from a network of physicians and hospitals which is authorized in advance by an individual's primary care physician. A Participating Provider Organization (PPO) is a network of physician and hospital providers offered by Blue Cross to PPO members. These providers have agreed to accept the Blue Cross payment schedule as payment in full for covered services. Plan A benefits are higher when provided by a PPO member. 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...

PPO members are not required to stay within the PPO network, but there is usually a strong financial incentive to do so. With NC SmartChoice, State members will save on their medical costs by avoiding deductibles and coinsurance for physician office visits. NC SmartChoice provides choice. State members will have three plan options, with varying levels of coverage to choose from. On the CMM plan, members must choose where to use the $150 wellness benefit. 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...

HMO plans typically have a limited network of providers and lower out of pocket costs for services. A primary care physician is usually selected and manages your health care and serves as a gatekeeper for referral to specialty care. PPO plans give economic incentives to patronize certain physicians, laboratories, and hospitals that agree to supervision and reduced fees. You may incur co-payments as well as deductibles, co-insurance, and out-of-pocket maximums for all covered services. See similar questions...

ClientCare and SELECT are similar in many ways. Both provide subscribers with unlimited technical support, as well as continuous product updates. However, SELECT also provides the following additional benefits: To access these additional benefits, users need to sign and return the SELECT agreement, and also cover all of their Bentley software under SELECT. 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...

Once you become a Blue Medicare HMO or Blue Medicare PPO member, you transfer the administration of your Medicare benefits to Blue Medicare HMO or Blue Medicare PPO. This means you maintain your status as a Medicare beneficiary, plus gain the enhanced coverage available through your Blue Medicare HMO or Blue Medicare PPO health plan. You will receive a Blue Medicare HMO or Blue Medicare PPO Member ID card that you will present when using your Blue Medicare HMO or PPO benefits. See similar questions...

Start by contacting your employer or insurance company. Under California's mental health parity laws (see below), certain conditions must be treated by the same rules as any other covered medical condition. (This contrasts with past practice, where treatments for mental illnesses were sometimes excluded or severely limited simply because these biologically-based conditions were traditionally classified as "mental" instead of "physical. See similar questions...

GEHA and Mail Handlers are nation-wide indemnity type plans will offering an HDHP with both in-network and out-of-network benefits. Your out-of-pocket expenses for covered medical services are limited to the catastrophic in-network limit of $5,250 for Self Only coverage and $10,500 for Self and Family coverage. It is important to remember once the catastrophic limit is met, you will not incur additional out-of-pocket covered medical expenses, including doctor visit co-payments and prescriptions. 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...