Choosing a Plan

HMO or PPO?

With a PPO plan, you:

Generally pay lower monthly premiums in exchange for higher out-of-pocket costs when you access care throughout the year.

Pay a percentage of charges for most covered services after you meet any plan deductible

Choose your own provider each time you seek medical care

With an HMO plan, you:

Usually pay higher monthly premiums so that your costs are lower when you access care throughout the year

Receive many covered services at no charge or for a fixed copayment

Choose a Physician from the HMO network, who will plan your medical care

Receive all medical services from your physician's medical group

Other Choices

Deductible-These range from zero dollar deductible plans to thousands of dollars. The deductible usually has to be paid before service copays/coinsurance start to be covered. (Many plans now offer a credit or a certain amount of physician visits a year even before the deductible is paid.)

Out of Pocket- This amount is the most an individual will have to pay for care in a year. The larger the Out-of-Pocket, the more an individual must pay before the insurance plan covers 100% of medical costs.

Prescription Coverage- Choices include generic only, comprehensive (generic and brand), and no prescription coverage. Some plans even have a prescription deductible.

Misc.- Maternity, Accupuncture, Chiropractic, Dental, and Vision Services vary per plan.