Health Alliance Medical Plans

HMO Plans
Plus Plans
POS Plans
PPO Plans
TPA Plans
Coordinated Care Plan (CCP)
Health Reimbursement Arrangements
Flexible Spending Accounts
COBRA Administration

Health Alliance HMO offers convenient access to quality health care at a high level of coverage. The HMO benefit plan covers routine physicals, well-child care, vision and hearing tests, prenatal care, immunizations, inoculations and more. Below is a summary of how our HMO plans typically work. If you have questions about our HMO plans, Contact Us.

Level of Coverage: HMO Plans typically offer the highest level of coverage. Except in emergency situations or when the member has received preauthorization from Health Alliance, members must receive care from in-network providers. Our provider network includes physicians, hospitals and pharmacies each chosen because of their reputation for excellence.
Primary Care Physicians: With a Health Alliance HMO plan, members select a Primary Care Physician (PCP) within our network of providers to coordinate all medical care. Members can change their PCP at any time by calling our Customer Service Department.
Referrals and Authorizations: If specialty care is needed, the PCP will refer the member to an in-network specialist. If the care needed is not available from a network provider, a Health Alliance Medical Director can authorize coverage for care outside the network.
Prescription Coverage: Employers choose to offer prescription drug coverage as part of their HMO benefit package. Typically, prescriptions require a copayment at the time they are filled. Most packages offer a “tiered” prescription benefit where the prescription selected determines how much the member pays.
Copayments, Coinsurance and Out-of-Pocket Maximums: Health Alliance HMO has no deductibles, no lifetime maximum benefit limits and minimal cost-sharing mechanisms such as copayments or coinsurance. Once a member has met the applicable copayment or coinsurance amount, Health Alliance pays 100 percent of the remaining covered charges.

All contents © 2007 Health Alliance Medical Plans. All rights reserved. Every effort has been made to ensure that this information is accurate. It is not intended to replace the legal source. In case of any discrepancy between this information and the legal source, the legal source will govern in all cases.

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