May 24 Covered CA Agents Webinar

[Dave020]

IFP HMOs have traditionally had much higher premiums than PPOs. I do note that it seems HMO across the board will be less expensive in the mix. Cost control.

Note that Anthem does not offer a PPO in any metro area. EPO instead, alongside the HMO. If you know how an EPO works, you can see massive cost control design in the metro areas.

 

[supersupps]

What would the reason be that ifp hmo have higher prem than ppo? My region also has epo from anthem..

 

[Dave020]

HMO has very little upfront cost to the subscriber compared to PPO. Most things that fall under the deductible of a PPO are at a co-pay on HMO (labs, diagnostics, xrays, mri, office visits and so on).

Most HMOs have low out of pocket around 3,000 or 3,500 and must include maternity in CA (now all plans do anyway).