Health Care Plans

For a comparison guide to the health care plans, please click on the following link:  2010 Health Care Basics:  The Formula for Making the Right Choice.

The Medical College of Georgia currently offers 6 health care plans:

• PPO / PPO Consumer Choice (PPO/PPOCC Plan Document)
• HSA PPO (HDHP) / HSA PPO (HDHP) Consumer Choice (HDHP Plan Document)
• HMO / HMO Consumer Choice (HMO/HMOCC Plan Document)  

Indemnity Health Care Plan

Effective January 1, 2010, the Indemnity Health Care Plan will no longer be offered as a health care option.  If you are currently enrolled in the Indemnity Health Care Plan, you must make an election for another health care plan during the Open Enrollment period.  Failure to make an election will default your current coverage to the PPO Health Care Plan.

PPO

The BlueChoice Preferred Provider Option (PPO) Health Plan is a comprehensive program which provides medical care/service coverage levels based on In-Network and Out-Of-Network services.  Enrolled employees/retirees and covered family members have the option of seeing whatever provider they like, however electing to see providers who are in the Blue Cross Blue Shield of Georgia (BCBSGa) Participating Provider Program or in the Blue Cross Blue Shield Association (BCBSA) BlueCard® Program will result in a higher level of benefit coverage and lower out-of-pocket expenses.

PPO Consumer Choice 

The BlueChoice Preferred Provider Option (PPO) Health Plan is a comprehensive program which provides medical care/service coverage levels based on In-Network and Out-Of-Network services.  Enrolled employees/retirees and covered family members have the option of seeing whatever provider they like, however electing to see providers who are in the Blue Cross Blue Shield of Georgia (BCBSGa) Participating Provider Program or in the Blue Cross Blue Shield Association (BCBSA) BlueCard® Program will result in a higher level of benefit coverage and lower out-of-pocket expenses.  Electing the Consumer's Choice plan provides you with the option of requesting that an out-of-network provider be given the option of becoming a preferred provider.  Note:  Your request does not guarantee that the provider will agree to join the network.

PPO / PPO Consumer Choice - Changes for 2010:  

Plan Design Changes: 

• A limited Extended Care Provision has been added to the PPO Health Care Plan for plan year 2010.

Network Changes:

• The BlueCard Network will be used without "In State"/"Out of State" differentials.
• Failure to access the BlueCard National Network will result in balance billing.
• A list of participating providers can be found on the following website:  www.bcbsga.com/bor/

Pharmacy Information:

• Will offer a Voluntary Mail Order Prescription Plan effective January 1, 2010.
  • Will be administered by Medco who currently handles the PPO Healthcare Plan Prescription Plan
  • A PPO Health Care Plan participant will be able to get a 90 day (3 month) supply of a prescribed maintenance medication at a reduced co-pay.
  • The web address for PPO Healthcare Participants to use to request renewal of their prescriptions is:  www.medco.com or call Member Services at 877.300-5139.

HSA PPO (HDHP) 

The BlueChoice Preferred Provider Option (PPO) Health Savings Account (HSA) compatible High Deductible Health Plan (HDHP) is an inexpensive comprehensive program that provides lower premiums and higher deductibles than the traditional PPO plan. The HDHP is designed specifically to be a federally qualified HDHP plan, compatible with Health Savings Accounts (HSA). As with other Preferred Provider Option (PPO) plans, medical care/service coverage levels are based on in-network and out-of-network services with in-network services providing lower out-of-pocket expenses. However, the annual deductible must be met before the plan benefits are paid.

HSA PPO (HDHP) Consumer Choice   

The BlueChoice Preferred Provider Option (PPO) Health Savings Account (HSA) compatible High Deductible Health Plan Consumer Choice (HDHP Consumer Choice) is an inexpensive comprehensive program that provides lower premiums and higher deductibles than the traditional PPO plan. The HDHP Consumer's Choice is designed specifically to be a federally qualified HDHP plan, compatible with Health Savings Accounts (HSA). As with other Preferred Provider Option Consumer Choice (PPO Consumer Choice) plans, medical care/service coverage levels are based on in-network and out-of-network services with in-network services providing lower out-of-pocket expenses. However, the annual deductible must be met before the plan benefits are paid. Electing the Consumer's Choice plan provides you with the option of requesting that an out-of-network provider be given the option of becoming a preferred provider. Note: Your request does not guarantee that the provider will agree to join the  network.

HSA PPO (HDHP) / HSA PPO (HDHP) Consumer Choice - Changes for 2010   

There are no plan design changes for plan year 2010.

HMO

The BlueChoice Health Maintenance Organization (HMO) Plan is a comprehensive program that provides Primary and Referral health care services. Enrolled employees/retirees and covered family members will be required to select a primary care physician (PCP) from the HMO network. The selected PCP will coordinate the medical services for a member and will issue a referral to a network specialist for specialty care as needed. PCPs include general practitioners, family medicine practitioners, internal medicine practitioners, and pediatricians. 

HMO Consumer Choice 

The BlueChoice Health Maintenance Organization Consumer Choice (HMO Consumer Choice) Plan is a comprehensive program that provides Primary and Referral health care services. Enrolled employees/retirees and covered family members will be required to select a primary care physician (PCP) from the HMO Consumer Choice network. The selected PCP will coordinate the medical services for a member and will issue a referral to a network specialist for specialty care as needed. PCPs include general practitioners, family medicine practitioners, internal medicine practitioners, and pediatricians. Electing the Consumer's Choice plan provides you with the option of requesting that an out-of-network provider be given the option of becoming a preferred provider. Note: Your request does not guarantee that the provider will agree to join the network.

HMO / HMO Consumer Choice - Changes for 2010  

There are no plan design changes for plan year 2010.