- These plans offer members the widest choice of providers with few restrictions on provider access
- Seeing a primary care physician (PCP) is not a prerequisite. No more PCP "gate keepers."
- Health care costs are lower when using the PPO network
- Increased costs and paperwork if the care is non-network
- Flexible co-pay and deductible options
- The HSA was created recently by federal legislation. An HSA lets you set aside pre-tax dollars for future medical, retirement, or long-term care premium expenses. Invest these funds as you wish within a broad range of choices, then use them for qualified expenses. The funds can roll over from year to year. You take them with you when you change jobs.
- To open an HSA, you must be enrolled in a qualified high-deductible health plan, as defined by the US Treasury. For 2006, the minimum annual deductible is $1,050 for a self-only plan or $2,100 for a family plan.
- HRAs consist of funds set aside by your employer to reimburse you for qualified medical expenses. Your employer can deduct the cost of an HRA as a business expense under IRS code. An HRA often provides "first-dollar" coverage for medical expenses subject to deductible, copays and coinsurance, until all funds are exhausted. Any unused funds roll over at the end of the year. Former employees and retirees can continue to withdraw unused funds from an HRA until the account is exhausted if they're enrolled in a retiree plan or COBRA. However, funds do not follow an employee to a new employer. HRA funds can't be rolled over to an HSA.
- FSAs are employer-sponsored benefit plans which allow you to set aside pre-tax dollars to cover qualified medical expenses. You contribute funds to the account through payroll deduction, then submit claims to reimburse yourself for qualified medical expenses. The funds you set aside in an FSA are not subject to income or Social Security taxes. FSAs are "use it or lose it" plans, which means you lose any money not claimed during the year. You can't claim funds for anything other than qualified medical expenses.
PacificSource does not have participating dentists. Members may visit any dentist, and PacificSource pays claims based on reasonable and customary charges for the area where services are rendered. Most dentists bill PacificSource directly using a standardized dental claim form. If a dentist does not bill PacificSource directly, the patient can send in the claim for reimbursement.