Appendix F
FEHB Plan Comparison Charts
Nationwide Fee-for-Service Plans
Fee-for-Service (FFS) plans with a Preferred Provider Organization (PPO) - A Fee-for-Service plan provides
flexibility in using medical providers of your choice. You may choose medical providers who have contracted with
the health plan to offer discounted charges. You may also choose medical providers who do not contract with the
plan, but you will pay more of the cost.
Medical providers who have contracts with the health plan (Preferred Provider Organization or PPO) offer discounted
charges. You usually pay a copayment or a coinsurance amount and do not file claims or other paperwork.
Going to a PPO hospital does not guarantee PPO benefits for all services received in the hospital, though. Lab work
and radiology services from independent practitioners within the hospital are frequently not covered by the hospital's
PPO agreement. If you receive treatment from medical providers who are not contracted with the health plan,
you either pay them directly and submit a claim for reimbursement to the health plan or the health plan pays the
provider directly according to plan coverage, and you pay a deductible, coinsurance or the balance of the billed
charge. In any case, you pay a greater amount of the out-of-pocket cost.
PPO-only - A PPO-only plan provides medical services only through medical providers that have contracts with the
plan. With few exceptions, there is no medical coverage if you or your family members receive care from providers
not contracted with the plan.
Fee-for-Service plans open only to specific groups - Several Fee-for-Service plans that are sponsored or underwritten
by an employee organization strictly limit enrollment to persons who are members of that organization. If
you are not certain if you are eligible, check with the Human Resources Shared Service Center (HRSSC), 1-877-477-
3273, option 5 first.
Fee-for-Service Plans Open to All
Fee-for-Service Plans Open Only to Specific Groups