What is the difference between the PPO (BlueCross BlueShield) and the HMO (Capital Health Plan) plans?
Flexibility and out-of-pocket expense. PPO: most inpatient and outpatient services, except for office visits, adult preventative care and Rx services are subject to the deductible and co-insurance. An individual may choose any provider the wish (there is a higher out-of-pocket expense if a non-PPO provider is used). There is coverage in or out of the state or country. If a PPO provider in another state is used, the benefit will be the same as if the services were provided in the State of Florida. HMO: there are no deductibles or co-insurances. There are copays only. An individual’s health care must be coordinated through their PCP (there are a few exceptions). There is no coverage, except for emergency services, out of the service area (Leon, Jefferson, Wakulla and Gadsden counties).
