If you have received a group health insurance quote from JME Insurance, you’ve probably noticed that there are several different network types — PPOs, POS plans, EPOs, and HMOs — to choose from. Here is more detailed information about each insurance carrier’s provider network and instructions so you can search for providers:
BCBSTX Network Options:
- When plan name contains CHC or PPO it means the plan utilizes the large Blue Choice PPO network. No Primary Care Physician (PCP) and no referrals are required. PPO offers coverage outside the network, but double the deductible and annual max out of pocket.
- When the plan name contains ADT it means the plan uses the Blue Advantage HMO network with required Primary Care Physician (PCP) and required referrals to see a specialist. No coverage outside the Blue Advantage HMO network.
BSW (Baylor Scott and White / Insurance Company of Scott and White) Network:
These are plans that use the Baylor Scott and White(BSW) system as their PPO network no PCP or referrals required inside the network. PPO offers coverage outside the network, but double the deductible and annual max out of pocket.
Plans marked as EPO means NO coverage outside the BSW system. Uses the BSW PPO network. Within system no PCP or referrals.
If a group has a member(s) outside the BSW system, they can select a POS plan which uses the PHCS network when outside the BSW area.
Humana plans shown use the Humana Choice Care PPO Network
United Healthcare (UHC) networks:
- UHC Choice Plus is their large PPO network. No PCP and no referrals required. Choice Plus offers coverage outside the network, but double the deductible and annual max out of pocket.
- UHC EPO uses the Choice network, but there is no coverage outside the network . PCP and referrals are not required.
- UHC Navigate uses the Choice network. It requires a PCP and referrals to specialists. No coverage outside the Choice network.