Compare Benefits and Providers
All HMOs are required by law to offer many basic benefits. However, other benefits are optional. And your choice of doctors and hospitals can also influence your decision.
Use the worksheet to evaluate a plan's benefits and services.
Decide which provider choices are important to you
- If you have providers you like, ask what plans they take.
- Do you want to see a certain doctor? Make sure the doctor is in the plan and is taking new patients.
- Do you want to see providers outside the network? You can do this in a PPO, but not in an HMO.
- Which hospital(s) will you go to?
- Can you get evening or weekend appointments?
- Ask if your choice of providers is limited by the medical group you choose. You can compare cost and quality ratings for medical groups.
Ask about benefits
- If you have a health condition, ask about services for the condition.
- If you take any prescription drugs, ask if they are covered.
Most health plans must provide language assistance services, including interpreters and translation of written materials. Group HMOs, Medi-Cal Managed Care plans and Medicare Advantage plans often provide more language services than other plans. Learn more about language access.
- A health plan should help you find providers whose offices and equipment are accessible to you.
- Some plans do a better job of this than others. Ask the plan what it can do to help you find accessible providers.
- Learn more about disability access. You can use the worksheets on communication assistance and physical access to list your needs.