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Types of Medical Plans

HMO (Health Maintenance Organization)

An HMO is a specific type of healthcare plan that sets guidelines under which doctors a patient can see. Traditionally, the monthly premium is higher than a PPO plan but there are less out-of-pocket expenses to the employee when the plan is used. The patient must choose a primary care physician (PCP) who is a member of the HMO. Referrals from the PCP are usually required when seeking services by a specialist. Unless an emergency, services provided by non-member providers are the patient’s full responsibility.

There is one HMO plan available in this area* (see the service area map)

Blue Shield Access+ HMO, Group Number W0051411

PPO (Preferred Provider Organization)

A PPO plan gives the patient more flexibility to see the provider of their choice. If the provider is “in-network”, the plan will pay more. Monthly premiums are less, but when the plan is used, you may incur more expenses than with an HMO.  View Anthem Blue Cross CalPERS Benefits Medical Plans for 2019 Summary of Benefits for Care, Select and Choice plans.

PPO plans available in this area are*:

PERSCare, Group Number KB030A

PERSCare 2018 Summary of Benefits

PERS Select, Group Number SB010A

PERS Select 2018 Summary of Benefits

PERS Choice, Group Number CB010A

PERS Choice 2018 Summary of Benefits

 

*Depending on your home address, other plans may be available to you. Contact the Benefits office if you would like to discuss your options.

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