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MANAGEMENT
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MANAGEMENT
Human Resources

Medical Plans

Choosing a Health Plan
Health Plan Rates
Health Program Guide
Benefit Summary Booklet

 

CalPERS Health Carrier Information

CalPERS Health Plan Search by Zip Code

HMO Plans

An HMO (Health Maintenance Organization) is a plan that provides healthcare from specific doctors and hospitals under contract with the plan. While you pay co-payments for some services, you have no deductibles, have an assigned Primary Care Physician (PCP), and a California geographically restricted service area.  The PCP manages all your care, including referrals to a specialist.  If you go outside of the HMO without a referral from the plan, you'll be responsible for the total cost of services, except for emergencies or urgent care services.

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PPO Plans

A PPO plan gives the patient freedom of choice, allowing to see a provider of choice without referrals. With PPO plans, you typically meet an annual deductible before some benefits apply. You are responsible for a certain co-insurance amount and the plan pays the balance up to the allowable amount.  If the provider is "in-network", the plan will pay more, than if the provider is "out-of-network".

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