Health Insurance Plan Comparison Chart
Health Maintenance Organization
Preferred Provider Organization
Point of Service
|Annual Deductible||No, most plans||Yes, most plans||No, for in-network coverage on most plans|
|Set Copayment Amounts||Yes||No||Yes, for in-network coverage|
|Coinsurance||Yes, some plans||Yes||Yes, for out-of-network coverage|
|Out-of-Network Coverage||Emergent care only||Yes||Yes|
|Primary Care Physician Required||Yes||No||Yes|
|Chiropractic Care or Spinal Manipulation Included||***Yes, QHP plans||Yes||***Yes, QHP plans|
|Individual and Family Coverage||Yes||****Yes||****Yes|
|Preventive Care||No charge||No charge (in-network only)||No charge (in-network only)|
|Health Savings Account (HSA)||Yes||Yes||Yes|
|Health Reimbursement Arrangement (HRA)||Yes||Yes||Yes|
|Flexible Spending Account (FSA)**||Yes||Yes||Yes|
*Optima Health does not require referrals for HMO plans; however other insurance carriers may require a referral for specialist treatment.
**Flexible Spending Accounts are generally offered by an employer and are not specifically tied to a health plan.
***Spinal manipulation is covered under all Affordable Care Act-compliant qualified health plans (QHP).
****Optima Health does not currently offer Individual & Family PPO or POS plans.
Funding Options for Consumer Driven Plans
Health Savings Account
Flexible Spending Account
Health Reimbursement Account
|Who Contributes?||Employee and/or Employer||Employee||Employee and/or Employer|
|Uses||Qualified medical expenses||Qualified medical expenses||Qualified medical expenses|
|Unused Funds at End of Year||Roll over to next year||Use it or lose it||Given back to employer|