Your benefits program offers you a choice of medical options for you and your eligible dependents to help cover the cost of medical expenses. Your medical options vary based on the individual plans and on how you want to control your out-of-pocket medical expenses.
An HMO covers only the services you receive from doctors, hospitals and other providers associated with the HMO. You usually pay only a small copayment for office visits and prescriptions - no deductibles and no claim forms. If you use a doctor that does not belong to the HMO, you pay the full cost for all non-emergency treatment and services.
A POS or PPO plan gives you a choice of receiving medical services in-network or out-of-network.
- In-network means you
receive care through a network of the Plan's participating physicians and
hospitals. In-network coverage is much the same as HMO coverage. There
is only a small copayment for office visits and prescriptions with no deductibles
or claim forms.
- Out-of-network means you can receive care from a doctor or hospital that does not belong to the Plan's provider network. When you receive out-of-network care, you usually pay more of the cost - a deductible or coinsurance - and you will need to submit a claim form to receive benefits.
A traditional plan also called an indemnity plan covers a percentage of all your medical expenses. You pay a deductible and a percentage of all covered expenses. You see any doctor and use any hospital you choose.
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