Types of plans
HMO - Health Maintenance Organizations
PPO - Preferred Provider Organizations
POS - Point-of-Service Plan
EPO - Exclusive Provider Organization
Health Maintenance Organizations (HMO)
Preferred Provider Organizations (PPO)
Point-of-Service Plan (POS)
High Premium, HMO and PPO
POS Network provider
Referral is required for out of network provider.
PCP not must.
Referral is not required for Emergency
Out of Network Provider accepted if PCP referred otherwise reimbursement will be less.
Deductible applied
No copay
Coinsurance applied
Exclusive Provider Organization (EPO)
Exclusive Provider Organization (EPO)-insurance plan allows access to health care from a network physician, facility or other health care professional, including specialists, without designating a Primary Physician or obtaining a referral- there is no claim forms or bills. Benefits are available for office visits and hospital care, as well as inpatient and outpatient surgery. Does not provide out of network.
What is an EPO Plan?
EPO plans are structured much the same as POS plans; however, out-of-network benefits are reduced. EPO plans are often compared to traditional HMO plans because a strong incentive exists to seek only in-network care.
Advantages of Physicians Care EPO Plans
EPO plans usually create the greatest degree of in-network utilization and therefore maximize the favourable impact of negotiated network rates or discounts.
In-network personal care physicians facilitate convenient and appropriate access to specialists for covered persons.
EPO plans usually have the lowest premiums or self-funded plan costs.
Is this plan right for me?
If most of the enrolled members in your group health plan reside in the Physicians Care Network service area, you probably have little need for out-of-network benefits. An EPO plan design might be a good choice. EPO plans are our most economical traditional health plan offerings.
Effective date
The date on which an agreement, such as a contract or insurance policy, takes effect (or) Beginning date of coverage for a current policy.
HMO - Health Maintenance Organizations
PPO - Preferred Provider Organizations
POS - Point-of-Service Plan
EPO - Exclusive Provider Organization
Health Maintenance Organizations (HMO)
Preferred Provider Organizations (PPO)
Point-of-Service Plan (POS)
High Premium, HMO and PPO
POS Network provider
Referral is required for out of network provider.
PCP not must.
Referral is not required for Emergency
Out of Network Provider accepted if PCP referred otherwise reimbursement will be less.
Deductible applied
No copay
Coinsurance applied
Exclusive Provider Organization (EPO)
Exclusive Provider Organization (EPO)-insurance plan allows access to health care from a network physician, facility or other health care professional, including specialists, without designating a Primary Physician or obtaining a referral- there is no claim forms or bills. Benefits are available for office visits and hospital care, as well as inpatient and outpatient surgery. Does not provide out of network.
What is an EPO Plan?
EPO plans are structured much the same as POS plans; however, out-of-network benefits are reduced. EPO plans are often compared to traditional HMO plans because a strong incentive exists to seek only in-network care.
Advantages of Physicians Care EPO Plans
EPO plans usually create the greatest degree of in-network utilization and therefore maximize the favourable impact of negotiated network rates or discounts.
In-network personal care physicians facilitate convenient and appropriate access to specialists for covered persons.
EPO plans usually have the lowest premiums or self-funded plan costs.
Is this plan right for me?
If most of the enrolled members in your group health plan reside in the Physicians Care Network service area, you probably have little need for out-of-network benefits. An EPO plan design might be a good choice. EPO plans are our most economical traditional health plan offerings.
Effective date
The date on which an agreement, such as a contract or insurance policy, takes effect (or) Beginning date of coverage for a current policy.
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