HAP

Plan types, coverage areas and networks

Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) are two types of managed care plans. Both plans are designed to reduce health care costs by focusing on preventive care and utilization management. It is important to understand the differences between these two types of plans, because choosing between them is one of the most important decisions you'll need to make when selecting a health plan.

Health Maintenance Organization (HMO)

How HMOs work

In a Health Maintenance Organization, otherwise referred to as an HMO, members select a Personal Care Physician (PCP), who coordinates all of their health care needs. Should a member need to see a specialist (Dermatology; Ear, Nose and Throat, Cardiology etc), we make it easy with paperless referrals. In addition, members are covered for emergency and urgent care wherever they go - worldwide. HAP also has a national network of pharmacies to use while traveling including Kmart® Rite Aid, Target®, Walgreens, Walmart® and CVS.

In certain Michigan counties, HAP offers HMO Choice plans which allow members to save money on premiums by working with a specific network, either the Henry Ford Choice network or the Genesys Choice network.

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HMO service area network

The service area is where HAP is licensed to sell the HMO plan and consists of the following 18 Michigan counties: Arenac, Bay, Genesee, Huron, Iosco, Jackson*, Lapeer, Livingston, Macomb, Monroe, Oakland, Saginaw, Sanilac, Shiawassee, St. Clair, Tuscola, Washtenaw and Wayne.

The network is the providers, doctors and hospitals associated with a plan type. HMO members use a subset of the statewide network within the nine-county service area. Check out HAP's Provider Search (You are leaving choosehap.org) to see which doctors and hospitals are available to HMO members in your area. Remember, with HAP's HMO you are only covered to see a doctor outside of the network when you have an emergency outside of the service area and visit an emergency room or urgent care center.

*Only 2017 plans are available for Jackson County.

Choice HMO Networks

HAP’s Choice networks give you access to a select group of leading doctors and hospitals. This lets you enjoy lower premiums, while still getting the same great care you would from a HAP-affiliated doctor. With a Choice network, your doctors, specialists and facilities are able to closely coordinate care, saving you time and money.

HAP offers two Choice networks: Henry Ford Choice network and Genesys Choice network.

Henry Ford Choice Network

This network is available to Michigan residents in Macomb, Oakland* or Wayne counties, which ensures the doctors and hospitals in the Henry Ford Choice network are located in your area.

The Henry Ford Choice network gives you access to:

  • Doctors and specialists within the Henry Ford Physician Network
  • Facilities within the Henry Ford Health System
  • In special cases, your PCP may refer you to C.S. Mott Children’s Hospital or University of Michigan
  • The entire HAP pharmacy network
In addition, members are covered worldwide for emergency and urgent care even if they travel outside of these counties.

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Henry Ford Choice plans are excluded from the following ZIP codes in Oakland County: 48356, 48357, 48346, 48348, 48359, 48360, 48362, 48442, 48370, 48371, 48462, 48367, 48350, 48353, 48428, 48430, 48439, 48455. HAP reserves the right to modify the specialist providers participating in the Choice program.

Genesys Choice Network

This network is available to Michigan residents in Genesee County, which ensures the doctors and hospitals in the Genesys Choice network are located in your area.

The Genesys Choice network gives you access to:

  • Doctors and specialists within Genesys Physician Hospital Organization
  • Facilities that are part of the Genesys Regional Medical Center
  • In special cases, your PCP may refer you to C.S. Mott Children’s Hospital, Henry Ford Hospital, Hurley Medical Center or University of Michigan
  • The entire HAP pharmacy network
In addition, members are covered worldwide for emergency and urgent care even if they travel outside of these counties.

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Preferred Provider Organization (PPO)

How PPOs work

In a Preferred Provider Organization, otherwise referred to as a PPO, members seek care from providers either in-network or out-of-network, without referrals. Each available plan has a Summary of Benefits which details both in-network and out-of-network coverage levels. Generally speaking, receiving care out-of-network incurs higher out-of-pocket costs. In addition, members are covered for emergency and urgent care wherever they go - worldwide. HAP's PPO customers can also use the national network of pharmacies both at home and while travelling, including Kmart®, Rite Aid, Target®, Walgreens, Walmart® and CVS.

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PPO service area network

The service area is where HAP is licensed to sell the PPO plans and consists of the following 21 Michigan counties: Arenac, Bay, Genesee, Gratiot, Huron, Iosco, Jackson*, Lapeer, Livingston, Macomb, Monroe, Oakland, Ogemaw, Roscommon, Saginaw, Sanilac, Shiawassee, St. Clair, Tuscola, Washtenaw, and Wayne.

The network is the provider locations, doctors and hospitals associated with a plan type. PPO members can use the statewide network of doctors and hospitals, which includes all Michigan counties as well as counties in Ohio and Indiana. Additionally, PPO members can access care nationwide through CIGNA's network of doctors. Check out HAP's Provider Search (You are leaving choosehap.org) to see which doctors and hospitals are part of the PPO network.


*Only 2017 plans are available for Jackson County.

Health Savings Accounts (HSAs)

How HSAs work

A Health Savings Account, otherwise referred to as a HSA, is an individually owned bank account. The money in an HSA can be used to pay for qualified medical expenses such as copays, coinsurance, deductibles, vision, dental services & more. HSA's typically have higher deductible plans and therefore lower premiums. So think higher out-of-pocketcost for services, but a lower monthly premium.

Any unused funds in your HSA savings account will rollover annually - you will never lose it. When you hit 65, you can use the money for things beyond qualified medical expenses like retirement.

HAP Personal Alliance HSA plans work with our PPO network, giving you access to both in and out-of-network doctors all over Michigan without requiring referrals and emergency and urgent care anywhere you travel.

HAP has trusted, integrated partners that can assist you in managing your HSA funds.

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