Managed Care Plans
Preferred Provider Organization (PPO) Plans
The Preferred Provider Organization (PPO) option offers employers and employees the widest choice of providers. When employees and their dependents use the NetCare Participating Provider Network, they have less out of pocket expense. If they choose to use a Non-network provider, they pay more out of pocket including any amount in excess of the Usual, Customary and Reasonable (UCR) charges for those services.
- The PPO Plans offered on Guam include the Standard Plan, Prime Plan and Access Deductible Plan
- The PPO Plans offered in the CNMI include the Preferred Plan, Standard Plan, Limited Plan and Prime Plan.
- The PPO Plans offered in Palau include the Preferred Plan and the Prime Plan.
Point of Service/Health Maintenance Organization (POS/HMO) Plans
The Health Maintenance Organization/Point of Service Benefit Plans offer a managed care service that allows members to direct their own care. At the point a member seeks services, the member can choose to coordinate care through his or her Primary Care Physician and receive a higher level of benefits; or the member chooses to self-direct or self-refer to a specialist physician or another primary care physician and receive benefits at a higher cost-sharing level.
The POS/HMO Plans offered on Guam include the Advantage POS Plan. The POS/HMO Plans is not offered in the CNMI and Palau.
Access Plan
Advantage Plan HMO
Advantage Plan HMO (GU Asia Network)
Advantage Plan POS
Advantage Plan POS (GU Asia Network)
Prime Plan
Prime Plan (GU Asia Network)
Prime Plan (GU PI Network)
Prime Reward Plan
Standard MOD Plan
Standard MOD Plan (GU PI Network)
Standard Plan
Standard Plan (GU Asia Network)
Standard Plan (GU PI Network)
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Preferred Provider Organization (PPO) Plans
The Preferred Provider Organization (PPO) option offers employers and employees the widest choice of providers. When employees and their dependents use the NetCare Participating Provider Network, they have less out of pocket expense. If they choose to use a Non-network provider, they pay more out of pocket including any amount in excess of the Usual, Customary and Reasonable (UCR) charges for those services.
- The PPO Plans offered on Guam include the Standard Plan, Prime Plan and Access Deductible Plan.
- The PPO Plans offered in the CNMI include the Preferred Plan, Standard Plan, Limited Plan and Prime Plan.
- The PPO Plans offered in Palau include the Preferred Plan and the Prime Plan.
Point of Service/Health Maintenance Organization (POS/HMO) Plans
The Health Maintenance Organization/Point of Service Benefit Plans offer a managed care service that allows members to direct their own care. At the point a member seeks services, the member can choose to coordinate care through his or her Primary Care Physician and receive a higher level of benefits; or the member chooses to self-direct or self-refer to a specialist physician or another primary care physician and receive benefits at a higher cost-sharing level.
The POS/HMO Plans offered on Guam include the Advantage POS Plan. The POS/HMO Plans is not offered in the CNMI and Palau.
Limited 8020 Plan
Limited Plan
Preferred Plan
Prime Plan
Standard Plan
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KMART SEARS
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