A Summary of Plan Options and Services

The chart that follows is intended to help you compare Fee-for-Service (or Indemnity), HMO and PPO plans as well as POS features. Plans will vary. Please consult specific policy descriptions for details on the plans or policies you are considering.

Plan Type	Claim Forms	Financial Structure	Preventive Care	Providers
Fee for Service (or Indemnity)	Patient files claim forms (Physician or other Provider may file as a courtesy.)	Deductible probable; co-pay on percentage basis	Not generally covered	Patient (member) can use any physician or facility; may require pre-approval process*
HMO	No claim forms	No deductible when service in network; typically low, pre-set co-payment	Emphasized: checkups, immunizations and early detection screenings covered	Usually use plan-approved providers accessed through a gatekeeper* (a primary care HMO physician)
PPO	No claim forms usually	Similar structure to HMO when service in network	Preventive care may not be covered; screenings are covered under some plans	Gatekeeper usually not required; can elect out-of-network provider usually at higher cost
POS Note: Adding a POS feature to a health plan	Claim forms may be required	In network, similar to HMO; out-of-network services may be higher in cost	Usually covered: checkups, immunizations and early detection screenings	No gatekeeper required; can elect out-of-network provider with pre-approval*

* except emergencies