Plan comparison
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HMO |
PPO |
EPO |
|---|---|---|---|
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Find doctors and providers online |
Yes - click here to find a doctor. |
Yes - click here to find a doctor. |
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Summary |
An HMO plan is traditionally a more affordable option, with care coordinated through a primary care physician. |
Members will have lower out-of-pocket costs when they stay inside of their network. Flexibility to seek services throughout Michigan as well as national coverage. |
Combines the cost savings of HMOs with the flexibility of a larger network of PPO providers throughout Michigan. |
| PCP | Members must choose a primary care physician. | Members are not required to choose a primary care physician. | Members are not required to choose a primary care physician. |
| Referrals for specialists required by HAP* | No* | No* | No* |
| Out-of-network coverage | Out-of-network care is not covered unless emergency. | Yes | Out-of-network care is not covered unless emergency. |
| Out-of-network emergency care | All HAP members have worldwide emergency and urgent care coverage, as well as access to 24/7 telehealth services. | ||
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Student coverage away from home (All plans always covered for urgent or emergency care, including mental health services.) |
Yes To obtain authorization for treatment or services, the student should contact a HAP Students Away coordinator by calling (248) 557-6271 (TTY:711) or email us at StudentAway@hap.org. For behavioral health concerns, such as depression or anxiety, call (800) 444-5755. |
Yes |
Yes To obtain authorization for treatment or services, the student should contact a HAP Students Away coordinator by calling (248) 557-6271 (TTY:711) or email us at StudentAway@hap.org. For behavioral health concerns, such as depression or anxiety, call(800) 444-5755. |
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Prescription drug coverage |
Yes |
Yes |
Yes |
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Preventive care programs |
Yes |
Yes |
Yes |
*Some services require prior authorization.
HSA & FSA benefits
A qualified high-deductible health plan (QDHP) paired with a health savings account (HSA) is a tax-free way to save money on certain out-of-pocket healthcare costs. The money in an HSA can be used to pay for out-of-pocket costs such as coinsurance, deductibles and copays. This can include costs for medical, prescription drug, dental and vision services and more.
Helpful resources
This short video explains benefits, deductibles, copays, coinsurance, and out-of-pocket maximums so you can make the right decisions.
Watch this short video to learn about cost sharing and using an HSA account.