Plan Comparison
| HMO | EPO | ||
|---|---|---|---|
| Find doctors and providers online | Yes - click here to find a doctor in the HAP network. | Yes - click here to find a doctor in the HAP network. | |
| Find doctors and providers for members who reside outside of Michigan | Yes - click here to find a doctor in the Aetna network. | Yes - click here to find a doctor in the Aetna network. | |
| Summary | An HMO plan is traditionally a more affordable option, with care coordinated through a primary care physician. | Combines the cost savings of HMOs with the flexibility of a larger network of PPO providers inside and outside of Michigan. | |
| PCP | Members must choose a primary care physician. | Members are not required to choose a primary care physician, but it is recommended. | |
| Referrals for specialists required by HAP* | No* | No* | |
| Out-of-network coverage | Out-of-network care is not covered unless emergency. | 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 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 | |
| Preventive care programs | Yes | Yes | |
| More Information | Click here to learn more. | Click here to learn more. | |
*Specialists may require a referral, but HAP does not. In some cases, the specialist may require a referral from a member’s PCP. Many specialists are booked out months in advance and may only accept patients whose PCP believes they need specialty care.