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HMOs in the FEHB Program

Two types of plans participate in the FEHB Program: fee-for-service plans and health maintenance organizations (HMOs). Health Maintenance Organizations Health Maintenance Organizations (HMOs) provide or arrange for comprehensive health care services on a prepaid basis through designated plan physicians, hospitals, and other providers in particular locations. Each HMO sets a geographic area for which health care services will be available, called its service area. This area is described in the plan’s brochure. You may join...

Fee-for-Service Plans in the FEHB Program

Two types of plans participate in the FEHB Program: fee-for-service plans and health maintenance organizations (HMOs) Fee-for-Service Plans These plans reimburse you or your health care provider for the cost of covered services. You may choose your own physician, hospital, and other health care providers. Most fee-for-service plans have preferred provider (PPO) arrangements. If you receive services from a preferred provider, you usually have lower out-of-pocket expenses (i.e., a smaller copayment and/or a reduced or waived...

Types of FEHBP Enrollment

In the FEHBP, there are two types of enrollment available, self only and self and family enrollment. Self Only A self only enrollment provides benefits only for you as the enrollee. You may enroll for self only even though you have a family, but they will not be eligible for FEHB coverage (even upon your death or disability). Self and Family A self and family enrollment provides benefits for you and your eligible family members. All of your eligible family members are automatically covered, even if you didn’t...

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