Is Florida Blue PPO or HMO?

Asked by: Alvina Littel II  |  Last update: April 18, 2023
Score: 4.2/5 (34 votes)

Florida Blue Medicare PPO Plans
Our PPO plans give you the opportunity to save with low out-of-pocket costs when you use in-network providers.

Does Florida Blue have a PPO?

PPO: Preferred Provider Organization

With a PPO plan, you're not required to have a primary care doctor and can see specialists without a referral.

Is Florida Blue care an HMO?

BlueCare HMO

Our traditional HMO plan, BlueCare, requires members to be assigned to a primary care physician. However, members are not required to receive services from their assigned primary care physician, and referrals are not required for specialist visits.

Is Florida Blue HMO the same as my blue?

The provider network that supports myBlue HMO is a sub-network of our existing Florida Blue HMO (Health Options, Inc.) primary care physician network along with other providers in the Florida Blue HMO network.

Does Florida have PPO?

Florida Blue offers PPO plans, which provide you with the most freedom to choose your doctors and health care service providers. This can be quite useful if you have a chronic condition or longstanding relationship with a physician and you don't want to start out treatment with a new doctor.

Understanding Your PPO & HMO Benefits

35 related questions found

Do doctors prefer HMO or PPO?

PPOs Usually Win on Choice and Flexibility

If flexibility and choice are important to you, a PPO plan could be the better choice. Unlike most HMO health plans, you won't likely need to select a primary care physician, and you won't usually need a referral from that physician to see a specialist.

What is state PPO plan Florida?

Plan Administrator

DSGI is authorized to provide health insurance coverage through fully insured or self-insured plans . This preferred provider organization (PPO) Plan is a self-insured plan . This means that claims are paid from a fund established by the State of Florida (State) .

What is PPO insurance?

A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan's network.

What is the difference between HMO and PPO?

To start, HMO stands for Health Maintenance Organization, and the coverage restricts patients to a particular group of physicians called a network. PPO is short for Preferred Provider Organization and allows patients to choose any physician they wish, either inside or outside of their network.

Is Florida Blue an advantage plan?

Florida Blue Medicare Advantage plan options

Florida Blue offers three Medicare Advantage plan types with different coverage levels and costs. HMO: HMOs save money by having one doctor coordinate your care with specialists and other health care providers.

Are EPO and PPO the same?

A PPO offers more flexibility with limited coverage or reimbursement for out-of-network providers. An EPO is more restrictive, with less coverage or reimbursement for out-of-network providers. For budget-friendly members, the cost of an EPO is typically lower than a PPO.

What is the difference between PPO and POS?

In general the biggest difference between PPO vs. POS plans is flexibility. A PPO, or Preferred Provider Organization, offers a lot of flexibility to see the doctors you want, at a higher cost. POS, or Point of Service plans, have lower costs, but with fewer choices.

What does HMO stand for in insurance?

A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage.

What is the difference between POS and HMO?

As with an HMO, a Point of Service (POS) plan requires that you get a referral from your primary care physician (PCP) before seeing a specialist. But for slightly higher premiums than an HMO, this plan covers out-of-network doctors, though you'll pay more than for in-network doctors.

What is an EPO plan vs HMO?

Regarding EPO versus HMO prices, EPO plans are usually more expensive than HMO policies but less expensive than PPO plans. EPO plans often have a more extensive network than HMO plans and do not give out-of-network benefits like PPO plans.

Why would a person choose a PPO over an HMO?

A PPO plan can be a better choice compared with an HMO if you need flexibility in which health care providers you see. More flexibility to use providers both in-network and out-of-network. You can usually visit specialists without a referral, including out-of-network specialists.

Does Florida blue cover out of state?

Most Blue Cross Blue Shield members can rest easy since Blue Cross Blue Shield coverage opens doors in all 50 states and is accepted by over 90 percent of doctors and specialists. And if your extended travel plans take you abroad, you can ensure you have access to quality care through GeoBlue.

What benefit does the PPO provide?

Similar to an HMO, PPOs have provider networks to save on health insurance costs. Providers in the network agree to accept lower payments in exchange for access to patients in the insurer's network. Unlike HMOs, however, PPO networks do provide some coverage for out-of-network care.

What is the largest PPO network in America?

The MultiPlan PHCS network is the nation's largest and most comprehensive independent PPO network. This network offers access in all states and includes more than 700,000 healthcare professionals, 4,500 hospitals and 70,000 ancillary care facilities.

Why are PPOs the most popular type of insurance?

PPOs are one of the most popular types of health insurance plans because of their flexibility. With a PPO, you can visit any healthcare provider you'd like, including specialists, without having to get a referral from a primary care physician (PCP) first.

Is a PPO worth it?

A PPO gives you increased flexibility and allows you to bypass seeing a primary care physician, every time you need specialty care. So, if you are a heavy healthcare user or have a large family, the flexibility of a PPO plan may be worth it.

What is the deductible for Florida Blue?

You can view the Glossary at or call 1-800-825-2583 to request a copy. Important Questions Answers Why This Matters: What is the overall deductible? In-Network: $250 Per Person/ $500 Family.

Does Florida have a state health insurance plan?

The State of Florida offers comprehensive health coverage to meet the needs of you and your family through a variety of health plans. Each plan is focused on helping you stay healthy through preventive care benefits as well as providing access to healthcare services when you need them.

Does CVS accept Florida Blue?

They can be self-administered and/or administered by providers. To help you meet the needs of your patients who take specialty medications, remember our members have the choice of two preferred in-network specialty pharmacies – CVS/Caremark Specialty and AllianceRx Walgreens Prime.

Why do doctors not like HMOs?

Since HMOs only contract with a certain number of doctors and hospitals in any one particular area, and insurers won't pay for healthcare received at out-of-network providers, the biggest disadvantages of HMOs are fewer choices and potentially, higher costs.