A PPO is a form of managed care, but it is more similar to a traditional "fee-for-service" type plan. PPOs contract with doctors, hospitals, and other providers to provide services for an agreed-upon charge. You must use the doctors in the network or pay a higher copayment. These plans are available statewide and outside of California.
Unlike an HMO, where a primary care physician directs all your care, a PPO allows you to select a provider and a specialist without referral. Generally, there are annual deductibles to meet before the plan will pay benefits. You're responsible for a certain percentage of the charges (copayments) and the plan pays the balance up to the agreed-upon amount. The covered benefits vary by plan.
The following link provides you with a summary and comparison of plan benefits and additional information links directly to the CalPERS website. Please refer to each plan’s Evidence of Coverage (EOC) booklet for the exact terms and conditions of coverage. In case of a conflict between this summary and your plan’s EOC, the EOC booklet determines the benefits that will be provided.
| PERS Choice (Blue Cross PPO) |
PERS-CARE (Blue Cross PPO) |
|---|---|
Group #: CB010 Telephone #: (877) 737-7776 Web: http://www.anthem.com/ca/calpers |
Group #: KB010 Telephone #: (877) 737-7776 Web: http://www.anthem.com/ca/calpers |
PERS Select |
Group #: Not available at this time Telephone #: (877) 737-7776 Web: http://www.anthem.com/ca/calpers/ |
