HMO medical plans

What you need to know

In a health maintenance organization (HMO), you and each covered dependent must choose a primary care physician (PCP) within the HMO network. The PCP coordinates all your care with providers within the HMO network.

How an HMO plan works

Pay nothing for preventive care in the HMO network. That includes services like screenings, immunizations, and exams.

You pay only copays when you get care. And there’s no coinsurance to pay, either.

Care outside the HMO network isn’t covered. Unless it’s an emergency situation.

Copays count toward the out-of-pocket maximum. Once you meet the out-of-pocket maximum, the plan pays 100% of covered services for the rest of the year.

Pharmacy benefits are provided by the HMO. You pay a copay for generic, brand, and non-brand prescriptions at in-network pharmacies. But prescriptions filled at an out-of-network pharmacy aren’t covered by the plan.

Certain medications cost nothing for Kaiser HMO and Health Net HMO members. Prescriptions for medications to treat diabetes, high blood pressure, and high cholesterol are provided at no cost to Kaiser HMO and Health Net HMO members when they are filled by in-network pharmacies.

HMO plans at a glance

You can enroll in an HMO if you live in one of these states:

Arizona: Health Net HMO
California: Kaiser HMO
Utah: SelectHealth HMO

Find out more about what these plans have to offer.

Kaiser HMO (CA)

Health Net (AZ)

SelectHealth HMO (UT)

Provider contact information

Important Information for Health Net of Arizona Plan Participants

Starting January 1, 2019, the Health Net HMO medical plan will no longer be an available medical plan option for PayPal employees residing in Arizona. Health Net is exiting the employer market in Arizona and will no longer offer its plans to any employer, including PayPal.

What does this mean for you? You don’t need to take any immediate action. You’ll remain covered through 2018 under the current Health Net HMO medical plan until the plan’s termination date on December 31, 2018. You won’t experience any change to your existing coverage or services for the remainder of this year – meaning you (and your covered dependents if applicable) can continue to use the plan as usual for the rest of 2018.

For 2019, PayPal will continue to offer medical coverage in partnership with UnitedHealthcare (UHC) through the $300 Deductible plan and the Consumer Directed Health Plan with Health Savings Account (CDHP with HSA). Both of these plans offer the wide range of UHC’s network of doctors, providing an expansive choice in care options.

We’re pleased to let you know that 98% of doctors that were accessed under the Health Net HMO are currently contracted with UHC. If your doctor is not currently contracted with UHC, you can nominate them to get recruited into UHC's network of doctors. Email UHCSupport_PayPal@uhc.com to submit the nomination.

Throughout the rest of this year, you’ll have an opportunity to review your new plan options to make the best decision during the upcoming Benefits annual enrollment period in November.

We understand you may have questions as we go through this transition. Review the FAQ and Resources links below. If you still have questions, contact PayPal Benefits at paypalincbenefits@paypal.com and PayPal’s Benefits team will assist you.

Onsite Events

PayPal Benefits will be hosting monthly information sessions onsite in Chandler and Scottsdale, as well as virtually, from June through November to assist you during this transition. Representatives from United Healthcare (UHC), CVS/caremark pharmacy and Health Equity will be in attendance.

Resources

Health Net notice to current members
PayPal email notice
PayPal mailing notice
FAQ
United Healthcare medical plans
Transition of care application

Contact Information

Health Net of Arizona

Discontinued as of 2019
800-289-2818
healthnet.com
PayPal Group Number: AJ889

United Healthcare (UHC)

Plan options for 2019
844-298-2737
welcometouhc.com/paypal
PayPal Group Number: 909006

CVS/caremark

Pharmacy Coverage
844-287-1297
caremark.com
PayPal Group Number: 1166

Health Equity

Health Savings Account for UHC CDHP plan participants
866-346-5800
healthequity.com/ed/paypal

If you have any questions, please contact paypalincbenefits@paypal.com.

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