b'Non-Medicare Health Insurance Options for Non-Medicare Eligible MembersOverview Health Maintenance Organization (HMO)The following pages offer general descriptions of the types of health insurance options for CTPF annuitants who are notCTPF offers the Blue Cross Blue Shield HMO Illinois plan. This eligible for Medicare. All CTPF health insurance plans includeplan includes both medical and prescription drug coverage. comprehensive medical and prescription drug coverage.The HMO does not have deductibles, coinsurance, or claim Specific plan information can be found in the charts onforms to file. All health care must be provided (except in pages 21-29.emergencies) by doctors, hospitals, and pharmacies that Chicago Public/Charter Schoolbelong to the HMO network. The HMO requires you to choose a primary care physician Continuation Coverage (PCP) to coordinate your care. Your PCP can be an internist, The Consolidated Omnibus Budget Reconciliation Actgeneral practitioner, or family practitioner. You have the of 1985 (COBRA), allows you to pay for the same healthoption to change your PCP at any time (changes may not be insurance coverage that you received during employment,effective immediately). You must seek a referral for specialty usually for 18 months.care and use network providers except in an emergency. A directory of providers is available online or directly from the Health insurance costs are generally lower under COBRAHMO. continuation coverage than they would be under a CTPFThe HMO service area is limited, so consider this option plan. Many choose this option and extend coverage for thecarefully if you travel frequently, do not live in the same maximum time allowed, normally 18 months. place for 12 months of the year, or have dependents living Under COBRA continuation coverage, you pay premiumsaway from home.directly to your former employer. The employer administers the program, determines eligibility, and processes applications. In order to maintain coverage, you must makePreferred Provider Organization monthly premium payments on time or your coverage may(PPO)be cancelled. Contact your employer for additional information. CTPF offers two PPO options, the Blue Cross Blue Shield PPO and UnitedHealthcare Choice Plus PPO. These plans include both medical and prescription drug coverage. A Preferred Provider Organization (PPO) is a network of physicians, hospitals, and other professionals that have agreed to accept established fees from a health plan.You decide whether or not to use a PPO network provider, NON-MED but plans generally pay a higher percentage of covered charges for services within the PPO network.20 CTPF 2021 HEALTH INSURANCE HANDBOOKCTPF 2021 HEALTH INSURANCE HANDBOOK'