HMO Provider

HMO

The HMO Plan That Works With You

HMO plans cover a complete array of in-network care with low out-of-pocket costs for all covered services.


Fits Member Needs and Budget

  • Affordable copayments for doctor visits.
  • No charge for certain preventive care, including routine annual physicals, immunizations, mammograms, Pap smears, and prostate cancer screenings.
  • A primary care physician (PCP) coordinates the member’s care and refers to network specialists as needed.
  • Routine preventive care and medical treatments provided and coordinated by the PCP.
  • Women may choose an OB/GYN to visit without a referral.
  • Worldwide coverage for emergency care.

Changing lives for the better. Another reason CDPHP has been recognized for top-ranked service and quality year after year.


This summary offers highlights but does not detail all benefits, limitations, or exclusions. It is not a contract and may be subject to change. For more detailed information, a Membership Certificate is available upon request.

Note: All non-emergency health services must be provided by a Capital District Physicians’ Health Plan, Inc. (CDPHP) participating physician/provider (including hospital admissions) unless otherwise pre-authorized by CDPHP.

Provider Access


The Secure Provider Site is your portal to member eligibility, claims information, and more.

FAQs

Learn about the common questions asked by CDPHP providers.

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