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SWA Benefits question
- Thread starter lowlycfi
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TrumanSparks
turn left at band aid
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Is PPO the same as EPO? I forget, but we signed up for the HMO as it provides for a lot of the well baby checks. The benefits people were not officially allowed to tell us what to pick, but they "Hinted" the HMO was the way to go with new kids. I think my daughter's birth cost about $150 at the local hospital in Phoenix. My wife does all the medical stuff, and has been very happy with the HMO, and the doctors that participate.
Good luck.
Good luck.
We have the Benefits plus PPO package. Costs us a couple hundred dollars total for pre-birth checkups (wife + sonagrams, etc), birth, emergency c-section,and a 4 day hospital stay afterwards. We were able to use our doctor of choice which I believe is one of the main differences between the PPO and HMO. We are very happy with the coverage that we got.
"Is PPO the same as EPO?"
No...two separate things. The EPO is a revised version of the HMO. As they say in our Benefits Department, it is "the Cadillac of HMOs."
With the PPO, you will pay a deductible ($200 for the employee only in 2005 I think, more if you have a wife or kids on your plan) before the insurance kicks in. After you pay the deductible, the insurance will pay a percentage of your medical costs. I think it's either 85% or 90% if you stay within the network. If you go out of the network, I believe the PPO will only pay 70% in 2005.
The HMO (technically called an EPO) is like a hybrid between the PPO and a traditional HMO. With this EPO, you do not have to get a referral from your primary care physician to go see a specialist (as you do with a traditional HMO). You can go see any specialist you want without a referral, so long as they are in the preferred provider directory. If you want to see a doctor who is not in the preferred provider directory, the EPO pays nothing. If the provider is in the directory, you just pay a co-pay of $15 for a general practioner, but I think you pay $25 for a specialist. But there are a LOT of providers in the directory. It's a pretty thick listing.
I've done both the PPO and this new HMO/EPO, and quite frankly, I liked the HMO/EPO better. The list of doctors to choose from is very long, and all of my doctors were on there. They should be...United Healthcare is a sizable insurance company.
With the PPO, be prepared to pay more out of pocket. At least that was my experience. The only thing that was better about the PPO was that, if I went out of the network, they'd pay a portion of my bill. However, considering that United Healthcare's list was so comprehensive, I never had a need to go out of the preferred provider network in the first place. So for me, the PPO was a waste of money.
It all depends on what you need. Listen to your Benefits Rep...I think he or she will come and talk to you within your first two days of class. Then choose what works best for you. And if you have questions, you can either talk to the Benefits Rep, or Southwest has a helpline where you can direct your questions.
Best of luck!
(forgive me if my dollar figures are somewhat off in this information...I admittedly have only briefly reviewed the PPO and HMO changes for 2005.)
No...two separate things. The EPO is a revised version of the HMO. As they say in our Benefits Department, it is "the Cadillac of HMOs."
With the PPO, you will pay a deductible ($200 for the employee only in 2005 I think, more if you have a wife or kids on your plan) before the insurance kicks in. After you pay the deductible, the insurance will pay a percentage of your medical costs. I think it's either 85% or 90% if you stay within the network. If you go out of the network, I believe the PPO will only pay 70% in 2005.
The HMO (technically called an EPO) is like a hybrid between the PPO and a traditional HMO. With this EPO, you do not have to get a referral from your primary care physician to go see a specialist (as you do with a traditional HMO). You can go see any specialist you want without a referral, so long as they are in the preferred provider directory. If you want to see a doctor who is not in the preferred provider directory, the EPO pays nothing. If the provider is in the directory, you just pay a co-pay of $15 for a general practioner, but I think you pay $25 for a specialist. But there are a LOT of providers in the directory. It's a pretty thick listing.
I've done both the PPO and this new HMO/EPO, and quite frankly, I liked the HMO/EPO better. The list of doctors to choose from is very long, and all of my doctors were on there. They should be...United Healthcare is a sizable insurance company.
With the PPO, be prepared to pay more out of pocket. At least that was my experience. The only thing that was better about the PPO was that, if I went out of the network, they'd pay a portion of my bill. However, considering that United Healthcare's list was so comprehensive, I never had a need to go out of the preferred provider network in the first place. So for me, the PPO was a waste of money.
It all depends on what you need. Listen to your Benefits Rep...I think he or she will come and talk to you within your first two days of class. Then choose what works best for you. And if you have questions, you can either talk to the Benefits Rep, or Southwest has a helpline where you can direct your questions.
Best of luck!
(forgive me if my dollar figures are somewhat off in this information...I admittedly have only briefly reviewed the PPO and HMO changes for 2005.)
At SWA I use the regular plan becuase there is no PPO or HMO in my area. I pay nothing out of my paycheck for myself, wife, and family. I have to pay a $250 deductible per person and get reimbursed 80% after the deductible. Once I pay out of pocket $2500 (that included the deductible) for the whole family I get reimbursed 100%. The regular plan doesn't cover physicals, but it lets mechoose any doctor that I want.
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