State Health Plan Coverage
The health insurance plans available to State members differ in the benefit levels they provide, the doctors and hospitals you can access and the out-of-pocket cost to you. In general, managed care plans, such as Health Maintenance Organizations (HMOs) and the Open Access Plan (OAP), deliver healthcare through a system of network providers and have a lower monthly premium than the Quality Care Health Plan (QCHP).
There are several managed care plans located throughout the state available to State members. In addition to managed care, the State plan offers the Quality Care Health Plan (QCHP), administered by Aetna beginning July 1, 2017, which allows plan participants to access any provider nationwide. Enhanced benefits are available for QCHP members who receive services from a QCHP network provider.
Benefit recipients may view a map of the various plans' coverage areas below:
Members will find a listing of providers who participate in the health plan's network when they go to the provider directory page on the plan's website.
The Affordable Care Act rules require health plans to provide a summary of benefits and coverage (SBC) and a glossary of health coverage and medical terms. Both are designed to make it easier for you to compare your options and understand exactly what you are buying. The new requirements will also make it easier for employers to compare health insurance options to provide for their employees. Members can view the summary of benefits and coverage for each plan. The benefit levels listed in the SBCs go into effect July 1st of each year.