WHAT IS A COOPERATIVE?
Health insurance owned by you
As a cooperative, CGHC is governed by a Board of Directors elected by our members and operated for the mutual benefit of our members. Also, any earnings we make are returned to our members in the forms of lower prices and improved services. This level of cooperation builds a strong bond between the people in the cooperative. We are all working toward the same goals – keeping members healthy and making health care as affordable as possible.
At Common Ground Healthcare Cooperative, our members come first and we are committed to providing trusted and understandable information. That’s why we make our health insurance plans simple to use and easy to understand. This isn’t always the case with other plans. When you’re choosing a health insurance plan, be sure to shop, compare and ask the right questions. The chart below can help you understand how we differentiate ourselves and put our members first.
|PRIMARY CARE PROVIDERS AND REFERRALS||CGHC does not require members to select a primary care doctor or get referrals to see specialists.||Many health plans require you to select a primary care provider from the start and then get referrals from that doctor to see other doctors and specialists.|
|PHARMACY NETWORK||CGHC does not limit you to certain in-network pharmacy providers.||Other plans may require you to use only certain in-network pharmacies.|
|IN-NETWORK COVERAGE||CGHC offers Exclusive Provider Organization (EPO) plans for individual and family coverage, which includes out-of-network coverage in emergencies and other limited circumstances.||Most plans on the market today are HMOs, which means you may not receive any coverage for non-emergency care received out-of- network and must select a primary care provider.|
|DEDUCTIBLES AND MAXIMUM OUT-OF-POCKETS||CGHC small group plans have separate deductibles only for care received from in-network providers versus out-of-network providers. Be sure you understand what separate deductibles are offered in your plan before you choose.||Other plans might have separate deductibles for things such as in-patient versus out-patient care.|
|EMERGENCY CARE||At CGHC, emergency care received from an out-of-network provider is covered as in-network including co-pays, coinsurance, deductibles and maximum out-of-pocket amounts.||While the ACA requires plans to apply the in-network copays and coinsurance rates for non-network emergency care, Some health plans do not apply these claims to the in-network deductibles and maximum out-of-pockets.|