HAP plan basics

Our plan types include health maintenance organizations, or HMOs; preferred provider organizations, or PPOs; and exclusive provider organizations, or EPOs. These types of plans focus on preventive care and reducing the cost of health care

HMOs

HMOs are usually more affordable than PPOs. HMO members coordinate their care through a primary care doctor. Though HAP doesn’t require you to get a referral from your primary care doctor to see a specialist, the specialist may require a referral. Check with the specialist’s office to find out if you need a referral from your primary care doctor before making an appointment. Find a doctor in our network.

Some of the advantages of HMO plans include:

• Ability to choose and change primary care doctors as often as you like
• Access to providers and hospitals within the HMO’s network
• Each covered family member can have a different primary care doctor

PPOs

PPOs offer more flexibility and choices. Some of the advantages of these plans include:

• No need to choose a primary care doctor
• Reduced out-of-pocket costs when you see in-network providers
• Members can see health care providers within or outside the PPO network without referrals

EPOs

EPOs combine the cost savings of HMOs with the flexibility of PPOs. These plans have the following advantages:

• Access to providers within the EPO’s network
• Larger service area than HMO plans
• No need to choose a primary care doctor

Our plan types include health maintenance organizations, or HMOs; preferred provider organizations, or PPOs; and exclusive provider organizations, or EPOs. These types of plans focus on preventive care and reducing the cost of health care

HMOs

HMOs are usually more affordable than PPOs. HMO members coordinate their care through a primary care doctor. Though HAP doesn’t require you to get a referral from your primary care doctor to see a specialist, the specialist may require a referral. Check with the specialist’s office to find out if you need a referral from your primary care doctor before making an appointment. Find a doctor in our network.

Some of the advantages of HMO plans include:

• Ability to choose and change primary care doctors as often as you like
• Access to providers and hospitals within the HMO’s network
• Each covered family member can have a different primary care doctor

PPOs

PPOs offer more flexibility and choices. Some of the advantages of these plans include:

• No need to choose a primary care doctor
• Reduced out-of-pocket costs when you see in-network providers
• Members can see health care providers within or outside the PPO network without referrals

EPOs

EPOs combine the cost savings of HMOs with the flexibility of PPOs. These plans have the following advantages:

• Access to providers within the EPO’s network
• Larger service area than HMO plans
• No need to choose a primary care doctor

We cover many health care services under our plans, including preventive services, urgent and emergency care, hospitalizations at affiliated facilities and more. Log in to your account for coverage details specific to your plan.

Our plans also include programs, services and discounts for members. These programs encourage healthy lifestyles and help you save money at popular retailers. Learn about our health and wellness programs, as well as our available discounts and services.

We also provide full coverage for spouses and dependents on your plan. We also cover children ages 5 to 26 who are away at school under our Students Away at School Program. Learn about dependent coverage.

With HAP prescription drug coverage, our goal is to make sure that you get the highest quality medications at the lowest possible cost. We cover a wide variety of drugs for our members with prescription drug coverage. HAP plans include a covered drug list, also known as a formulary, to keep you informed about the drugs we cover. We are committed to ensuring that our members have access to safe, cost-effective and high-quality drugs.