Network guide: HMO vs. PPO

To help you make the right choice for you and your family, here's a quick guide to the differences between our HMO and PPO Plus plans.

HMO

  • In-network coverage only
  • Premiums may be lower with HMO plans
  • Your PCP coordinates your care
  • You need referrals for specialty care and certain services

PPO Plus

  • In- and out-of-network coverage
  • Premiums may be higher with PPO plans
  • PCP is recommended but not required
  • No referrals necessary for specialty care

Explore 2023 plans

Complete plans

Complete plans provide full access to our world-class HMO or PPO Plus networks. To view PPO Plus cost sharing for out-of-network providers (PCPs and specialists), check plan details.
 







Plan Name Annual Individual Deductible Family Deductible Office Visit Copay - PCP Office Visit Copay - Specialist Plan Documents
Complete HMO 20/40 $0 $0 $20 $40
Complete HMO 30/55 $0 $0 $30 $55
Complete HMO 1000 35% $1,000 $2,000 $25 $45
Complete HMO HSA 2000 30/60 Enhanced FlexRx* $2,000 $4,000 (D) $30 (D) $60
Complete PPO Plus 2000 30/60/350* $2,000 $4,000 $30 $60
Complete HMO 2000 30/60/350 $2,000 $4,000 $30 $60
Complete HMO 2850 $2,850 $5,700 (D) $30 (D) $65

*Only available to small groups

 

Shop Connector plans
 
Select HMO and Select ConnectorCare plans can be found here
 

Search for covered drugs in our Formulary

See the 6-Tier drug list here.

 

Information about 2023 rate increases

Read information about 2023 rate increases here.