This plan gives you access to our health maintenance organization (HMO) network. You’ll choose a health center and primary care provider to coordinate all your care.
$1,500 per person
$3,000 maximum per family
This plan pays for 90 percent of most health care costs after the deductible is met. You’ll pay the remaining 10 percent.
$2,000 per person
$4,000 maximum per family
This plan pays for 80 percent of most health care costs after the deductible is met. You’ll pay the remaining 20 percent.
This plan pays for 75 percent of most health care costs after the deductible is met. You’ll pay the remaining 25 percent.
*Annual deductible applies
If your plan has a deductible, it's the amount you pay each calendar year for certain services and products before your health plan pays.
The deductible doesn't apply to services such as preventive care, in-network primary care office visits, in-network specialist office visits, and in-network outpatient laboratory and pathology services.
The out-of-pocket maximum is the most you'll have to pay per plan year for covered health care services. Once you reach this amount, your plan pays 100 percent of the allowed amount for covered services excluding taxes.
There's a maximum for each person on the plan and a maximum for everyone on the plan.
Providers in our network agree to charge set rates for services or products.
Providers who aren't in our network are called out-of-network providers. It usually costs more to see these providers because they don't have a contract with us to provide you with services at a set fee. In addition, visits to out-of-network providers may not apply to your plan's deductible.
Here are a few things you may want to consider when choosing a plan.
Find a plan that fits your budget.
See which type of provider network is right for you.
Decide what level of protection you need.
The total cost of your health insurance depends on your plan's premiums and out-of-pocket costs. Knowing how these work and what you're paying for can help make sure you’re not spending more than you need to.
Premiums are the payments you make for your health plan. You may pay the entire premium or just the part not covered by your employer, usually monthly.
When seeing a doctor, plans either mention a copayment or coinsurance, which is the amount you pay for covered services. The cap on your out-of-pocket costs is your out-of-pocket maximum.
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When you’re choosing a health plan, one of the main things to consider is the plan’s network of doctors. Each health plan has a group of doctors who have an agreement with the health plan to charge a set amount for services. It’s best to see providers in our network to get the best value.
There are two types of plans with different doctor networks, preferred provider organization (PPO) and health maintenance organization (HMO) plans.
PPO plans let you see any provider you prefer in HMSA’s network of participating providers. PPO plans work best for people who value the freedom to choose.
HMO plans require you to pick one health center and a primary care provider (PCP) in that health center to provide or arrange your care. Your PCP will refer you to specialists and other health care providers in your health center when you need it.
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Manage your financial risk against a major health event through a plan’s annual out-of-pocket max.
The out-of-pocket maximum is the most you will have to pay for health services for the calendar year. In the case of a major health event, where your out-of-pocket costs may amount to a number larger than you can handle, an out-of-pocket max is an important safeguard for you and your family.
The lower a plan's out-of-pocket maximum, the lower your financial risk for the plan year. However, you’ll usually pay higher premiums for more financial protection.
I'd like to...
Because you told us that you would like to keep premiums low, keep out-of-pockets costs low, have the freedom to choose your doctor choose a health center and have financial protection from high health care costs have lower premiums , you may want to consider the following plans:
If a plan meets your criteria, up to three badges will display under the plan name.