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 PPO allows members to seek treatment from the physician of their choice, but members will pay less out-of-pocket when they receive care from a preferred provider. Health Alliance PPO plans are cost-effective because we arrange for discounts with preferred providers and offer greater coverage to members who choose them. Below is a summary of how our PPO plans typically work. If you have questions about our PPO plans,
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Preferred Providers: We have a large network of preferred providers. These physicians, hospitals and pharmacies have been selected to be part of the Health Alliance network because of their reputation for excellence. By contracting with such a large number of providers, we are able to offer members convenient access to health care. Members choose the providers that work best for them from the Health Alliance network.
Referrals and Authorizations: Although it is recommended that members establish a relationship with a primary care physician (PCP) to coordinate their care, PPO plans do not specifically require this. If members require the care of a specialist, the member’s personal physician can make sure he or she is referred to the appropriate provider.
Prescription Drug Coverage Option: Employers may choose to offer prescription drug coverage as part of the PPO 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.
Personal Expense Limits: In the event of a catastrophic illness or injury, Health Alliance has placed a limit on the member’s personal expenses. After a member has reached their limit, all covered medical expenses are paid by Health Alliance until the beginning of the next benefit year. Personal expense limits differ for preferred and non-preferred services.

All contents © 2009 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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