GROUP MEMBER
Explore Group Plan Types
Learn about the types of health care plans. One of these types may be part of your group coverage. Do you already have your BCBSIL member ID card? Sign up for Blue Access for MembersSM now.
HMO? PPO? Learn About the Different Types of Plans
Health plans are often referred to as either HMO or PPO. There’s also a third type of plan, called Consumer Directed Plans that include a special savings account.
Plan Types At-a-Glance
Here’s a quick comparison of the three types of group plans. Note: This comparison offers a broad glimpse of differences. Every health plan is unique. Your employer may offer several plan choices. Be sure to compare coverage, costs and other key features. Review your plan information and choices with your benefits team.
| KEY PLAN FEATURES | HMO | PPO | CDHP |
|---|---|---|---|
| Provider network | Health care is managed through a PCP within the plan network | Greater flexibility and choice to see providers in and out of the plan network | Varies by plan; BCBSIL group plans are high-deductible PPO plans |
| Health care outside of plan network | In most cases, you won’t have coverage for services outside the plan network | You’ll have coverage outside the network, but you may have to pay more out-of-pocket | Varies by plan; BCBSIL offers PPO out-of-network coverage |
| Specialist referrals | Your PCP must provide a referral | Freedom to see a specialist or behavioral health provider without a referral | Varies by plan; BCBSIL plans work like a PPO |
| Out-of-pocket costs | Generally lower than a PPO plan | Generally higher than an HMO plan | High deductible |
| Deductibles | Often a lower deductible than a PPO plan | Often a higher deductible than an HMO plan | Higher deductible than many plans |
| Health Savings Accounts (HSA) qualified | May qualify if it is a high-deductible plan and designated as HSA-compatible | May qualify if it is a high-deductible plan and designated as HSA-compatible | Having a CDHP plan qualifies you for an HSA |
