BENEFITS
PORTAL
PORTAL
PPO v.s. HMO v.s. H.S.A.
WHAT IS A PPO
PPO Stands for Preferred Provider Organization. Your PPO coverage provides you benefits that allow you
to see doctor’s and specialist’s In and Out of the insurance carriers network. A PPO does not require you to
pick a Primary Care Physician, allowing you to have more freedom to see the doctor’s you want to see.
Will I get charged more if I utilize an OUT OF NETWORK Doctor?
When you do not use IN NETWORK providers, you need to be aware that you may pay more for services
that are rendered by that provider., because this OUT OF NETWORK provider does not have a contract
with your insurance company. Therefore, you always receive the highest level benefits when you see an IN NETWORK
Provider.
WHAT IS AN HMO:
PPO Stands for Preferred Provider Organization. Your PPO coverage provides you benefits that allow you
to see doctor’s and specialist’s In and Out of the insurance carriers network. A PPO does not require you to
pick a Primary Care Physician, allowing you to have more freedom to see the doctor’s you want to see.
Will I get charged more if I utilize an OUT OF NETWORK Doctor?
When you do not use IN NETWORK providers, you need to be aware that you may pay more for services
that are rendered by that provider., because this OUT OF NETWORK provider does not have a contract
with your insurance company. Therefore, you always receive the highest level benefits when you see an IN NETWORK
Provider.
WHAT IS AN HMO:
HMO stands for Health Maintenance Organization. HMO coverage requires you to pick a Primary Physician,who
will coordinate your care. If you need to see a specialist, they will often refer you to the specialist affiliated with the
your same medical group. You can change your Primary Care Physician once a month, as long as you
call the insurance carrier before the 20th of the month .Your change of provider will be effective the following month.
Can you utilize OUT OF NETWORK Doctor’s on the HMO plan?
NO, there is no coverage for OUT of NETWORK providers. Your Primary care Physician coordinates all of your care
within the medical group.
WHAT IS AN H.S.A.:
H.S.A stands for Health Saving Account. H.S.A. Plans are PPO plans that have high deductibles, and usually
provide a high level of coverage after you meet this deductible. All services except for a few preventative services
mandated by federal law, are subject to the high deductible, including prescriptions. Since this is a PPO plan
you can see IN NETWORK and OUT OF NETWORK providers.
What is a Health Savings Account?
When you enroll in an H.S.A. plan you have the opportunity to start an H.S.A. Account at your local bank.
You are allowed to make regular or irregular deposits to these accounts and receive a FEDERAL TAX
DEDUCTION for any amounts that you deposit to this special account within the contribution limits. You will
receive a DEBIT CARD in order to access the funds in the account. However, unless you use the debit card
for one of the two hundred approved services, the I.R.S. will assess you the same penalties that an early distribution
on an IRA would have. Any funds that are unused at the end of the year will rollover until the next year. These
funds are not “use it or lose it” (Please contact us if you have any further questions about the H.S.A. Plans)
NO, there is no coverage for OUT of NETWORK providers. Your Primary care Physician coordinates all of your care
within the medical group.
WHAT IS AN H.S.A.:
H.S.A stands for Health Saving Account. H.S.A. Plans are PPO plans that have high deductibles, and usually
provide a high level of coverage after you meet this deductible. All services except for a few preventative services
mandated by federal law, are subject to the high deductible, including prescriptions. Since this is a PPO plan
you can see IN NETWORK and OUT OF NETWORK providers.
What is a Health Savings Account?
When you enroll in an H.S.A. plan you have the opportunity to start an H.S.A. Account at your local bank.
You are allowed to make regular or irregular deposits to these accounts and receive a FEDERAL TAX
DEDUCTION for any amounts that you deposit to this special account within the contribution limits. You will
receive a DEBIT CARD in order to access the funds in the account. However, unless you use the debit card
for one of the two hundred approved services, the I.R.S. will assess you the same penalties that an early distribution
on an IRA would have. Any funds that are unused at the end of the year will rollover until the next year. These
funds are not “use it or lose it” (Please contact us if you have any further questions about the H.S.A. Plans)
