Your medical plan options

EPO: The Exclusive Provider Organization

The EPO plan may be right for you if:

• You want to pay lower monthly premiums.
• You want flexibility in choosing providers with the lowest out-of-pocket costs (copay and coinsurance) when you visit a provider in the PeaceHealth and ZoomCare Network (Tier I).
• Most of your care comes from Tier I providers (including ZoomCare, PeaceHealth, CIN community providers and Joint Ventures).
• You live near Tier I providers. 
• You do not use any out-of-network providers. 

PPO: The Preferred Provider Organization

The PPO plan may be right for you if:

• You don’t mind paying more in premiums for increased flexibility in choosing providers.
• You seek care from both Tier I and Tier II providers but want to pay lower out-of-pocket costs when seeing Tier II providers than under the EPO.
• You want coverage when going out-of-network for some care. 

ABHP: The Account-Based Health Plan

The ABHP plan may be right for you if:

• You want to pay less each month for your plan.
• You want flexibility in choosing providers and seek care from both Tier I and Tier II providers but don’t mind paying higher deductibles and out-of-pocket costs.
• You would like to contribute money into a health savings account (HSA), in addition to the contributions made by ZoomCare. An HSA helps you save pre-tax dollars for your healthcare expenses (deductibles, coinsurance and prescription drugs) and lowers your taxable income. Note: if you or your family members have chronic or high-cost conditions this plan may not be right for you. While preventive care is covered at 100%, all other services require that you meet the higher deductible. If you have family members enrolled, the family deductible must be met before the plan begins to provide benefits for any family member.