Choosing a Plan: PPO Plus vs PPO Plus HSA

We know plan selection can be a scary process, but it doesn't have to be. We got you. Here are the primary differences between our two plan types. 

You'll notice both plans are PPO Plus. This means you can see any in or out-of-network providers without paying out-of-network fees.

PPO Plus Plans

Our PPO Plus plans offer excellent coverage from day one. You’ll pay higher monthly premiums than you would with our HSA plans, but have the peace of mind that most of your visits will cost just a small copay. Furthermore, you’ll have 100% free access to all of our Care Partner providers.

Choosing between PPO Plus Plans

• Premium and Superior (P & S) plans are ideal if you prefer constant coverage with lower deductibles and coinsurance.
  
• Core, Basic, and Essential (C, B, E) plans are ideal if you want low copays on most types of visits, but don’t mind a higher OOPM and coinsurance responsibility.

PPO Plus HSA (H) Plans

Our PPO Plus HSA plans give you and your employer the opportunity to pay into a Health Savings Account (HSA) each month to cover medical expenses. Before selecting this plan, check with your employer to see what their monthly contribution will be if any.

PPO Plus HSA plans are ideal if you don’t plan on going to the doctor much and you don’t mind the risk of paying full price for visits until you meet your deductible.

Per IRS guidelines, cost-sharing starts after you meet your deductible. Furthermore, you’ll only have free access to select Care Partner providers. 

PPO Plus HSA plans have lower premiums and higher deductibles than most of our PPO Plus plans. Members covered by a PPO Plus HSA plan typically contribute to a Health Savings Account (HSA).

How a PPO Plus HSA Plan Works

Members pay all medical costs out of pocket until the deductible is reached. Once the deductible is met, the member is responsible for coinsurance or copay amounts until the out-of-pocket max is reached. At that point, the plan pays for 100% of covered expenses.

If you visit a doctor regularly, have a major procedure coming up, take specialty medications, or tend to spend a lot of money on healthcare, you may not be interested in a PPO Plus HSA plan.

Health Savings Accounts

If you have a PPO Plus HSA plan, you probably also have a health savings account (HSA) — an IRS-regulated benefit that allows members with high deductible plans to contribute pre-taxed funds to help pay for certain medical expenses.