The two basic types of health benefits plans available to you under the FEHB Program are fee-for-service plans and prepaid plans.
Fee-for-Service Plans
These plans reimburse you or the health care provider for covered services. If you enroll in one of these plans, you may choose your own physician, hospital and other health care providers.
Fee-for-service plans include the Service Benefit Plan administered by Blue Cross and Blue Shield and plans sponsored by unions and other employee organizations.
The Blue Cross and Blue Shield plan is open to all Federal employees. Some employee organization plans are open to all Federal employees who hold full or associate memberships in the organizations that sponsor the plans; the other employee organization plans are restricted to employees in certain occupational groups and/or agencies. Generally, the employee organizations require you to pay a membership fee or dues in addition to your health plan premium. (Such membership charges are paid directly to the employee organizations and are not part of the FEHB Program.)
Prepaid Plans
These are the Comprehensive Medical Plans/Health Maintenance Organizations (CMP/HMOs) that provide or arrange for health care by designated plan physicians, hospitals, and other providers in particular locations. CMP/HMOs are either Group Practice Plans, Individual Practice Plans or a combination of both (called Mixed Model Plans). Group Practice Plans provide care through a group of physicians who practice at medical centers operated by or under contract to the plans. Individual Practice Plans provide care through participating physicians who practice in their own offices.
Each CMP/HMO is open to all Federal employees who ii within the plan's enrollment area. It is very important that you are sure you live in the plan's enrollment area before you enroll in one of these plans. The enrollment area is described in the plan's brochure.