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Health Plans

Health Maintenance Organizations (HMOs)

HMOs offer you a range of health benefits, including preventive care, for a monthly fee, with no deductibles or maximums. They also set co-payments for the care you receive. The HMO will give you a list of doctors for your use in choosing a primary care physician (PCP). The PCP coordinates 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.

HMOs are available only in designated California service areas. To see which plans are available where you live or work, use our  Health Plan Search By ZIP Code online service. Kaiser Permanente is available in some other states, although the covered benefits can vary.

Preferred Provider Organizations (PPOs)

A PPO is similar to a traditional "fee-for-service" plan, but you must use doctors in the PPO provider network or pay higher co-insurance (percentage of charges). A PPO allows you to select a primary care provider and specialists without referral. In these plans, you must usually 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.

Note: The PORAC plan is available only to dues-paying members of those organizations and their families.