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.eligible for Medicare. All CTPF health insurance plans includeThis plan includes both medical and prescription drug comprehensive medical and prescription drug coverage.coverage. Specific plan information can be found in the charts onThe HMO does not have deductibles, coinsurance, or claim pages 16-23.forms to file. All health care must be provided (except in emergencies) by doctors, hospitals, and pharmacies that Chicago Public/Charter/Contractbelong to the HMO network. School Continuation Coverage The HMO requires you to choose a primary care physician (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 or until you become Medicare eligible.care and use network providers except in an emergency. Health insurance costs are generally lower under COBRAA directory of providers is available online or directly from continuation coverage than they would be under a CTPFthe HMO. plan. Many choose this option and extend coverage for theThe HMO service area is limited, so consider this option maximum time allowed, normally 18 months. carefully if you travel frequently, do not live in the same Under COBRA continuation coverage, you pay premiumsplace for 12 months of the year, or have dependents living directly to your former employer. The employer administersaway from home.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 be cancelled.(PPO)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.14 CTPF 2023 HEALTH INSURANCE HANDBOOKCTPF 2023 HEALTH INSURANCE HANDBOOK'