Selecting a Plan: Making the Right Choice

Stanford offers a variety of medical plan options to help you meet the health care needs of you and your family. Choose from five types of medical plans: Health Maintenance Organization (HMO), Stanford Healthcare Alliance (SHCA), Exclusive Provider Organization (EPO), Preferred Provider Organization (PPO) and High-Deductible Health Plan (HDHP). Contact the individual plan carriers for answers to your health care questions.

Things to keep in mind when selecting a medical plan:

• Where do you typically receive care and are those providers/hospitals part of a plan's network;
• Do you need a plan that allows access to non-network providers;
• What are the co-payments and deductibles;
• How much will it cost per month from my paycheck;
• Do I want access to a Health Savings Account (HSA) as part of my strategy for saving for healthcare in retirement.

Kaiser Permanente HMO

For full-time employees, the Kaiser Permanente HMOKaiser HMO Plan Summary - 2015
Detailed plan document for the Kaiser HMO plan. Includes information about coverage, benefits, copays and coinsurance, eligibility, claims, and grievance procedures.
plan is offered at no cost when you cover yourself only. If you have eligible dependents, you pay a portion of the cost of their coverage. Under the Kaiser HMO, you do not have to select a primary care physician (PCP) when you enroll, but you must get your care at a Kaiser facility. Emergency care is covered worldwide.

For your convenience, a Kaiser mobile clinic is on campus Tuesdays and Thursdays, and at SLAC the first Thursday of each month. The mobile clinic provides a wide range of primary care services. To find the location and set up an appointment, go to http://mydoctor.kaiserpermanente.org/ncal/healthCenter/mhv/ or call 800-464-4000.

Stanford Healthcare Alliance

Group #976248. The SHCA medical planStanford HealthCare Alliance FAQs
Brochure showing Stanford HealthCare Alliance (ACO) plan benefits, deductibles, co-pays, and coverage levels at non-network providers for a variety of commonly-used medical treatments and services.
is offered at no cost when you cover yourself only. You are required to designate a primary care provider to coordinate all of your care, and must receive your care at a SHCA network facility. Emergency care is covered worldwide. To find a provider go to stanfordhealthcarealliance.org or call 1-855-345-7422.

Blue Shield EPO

Blue Shield Group #976109. The Blue Shield EPOBlue Shield Exclusive Provider Organization (EPO) FAQs
Common questions about the Blue Shield Exclusive Provider Organization (EPO) health insurance plan available at Stanford.
requires you to see a Blue Shield provider when you access care. The network of providers for the EPO plan is the same as that for the PPO and High Deductible plans.

Blue Shield PPO

Blue Shield Group #170292. The Blue Shield PPOBlue Shield PPO Plan Summary - 2015
Detailed plan document for Blue Shield PPO Plan (Group 170292). Includes information about eligibility; costs and cost sharing; included and excluded services; claims process; procedures for filing grievances, complaints, and appeals.
plan allows you the freedom to go to any network provider or to the provider of your choice outside the network. While the choice is yours, each time you need care, your out-of-pocket costs are substantially lower and more predictable when you go to a Blue Shield network provider.

Blue Shield High-Deductible Health Plan

Blue Shield Group #170293. The High-Deductible Health PlanBlue Shield High-Deductible Health Plan Plan Summary - 2015
Detailed plan document for Blue Shield High Deductible Health Plan (Group 170293). Includes information about eligibility; costs and cost sharing; included and excluded services; claims process; procedures for filing grievances, complaints, and appeals.
plan works the same as the Blue Shield PPO plan, but with a much larger out-of-pocket deductible. There are no copayments with this plan. Instead, all benefits, including prescription drugs, are covered after you meet your deductible. What you pay when you see your doctor or get a prescription may be less than you think. Here are some examples of out-of-pocket costsBlue Shield High Deductible Health Plan - Think About It
Brief overview of the Blue Shield High-Deductible Health Plan, with cost comparisons.
with the high-deductible PPO plan. This plan qualifies for a personal Health Savings Account (HSA), which allows you to put money aside on a tax-deductible basis to pay for medical expenses.

Logon to MyBENFITS in the upper right corner of this page for Planning Tools

Learn more about Health Savings Accounts.