The main advantage of a POS plan is its flexibility. It combines the lower costs of using in-network providers, as in HMOs, with the option to go out-of-network, as in PPOs. The disadvantage is the need for referrals to see specialists and potentially higher costs for out-of-network care compared to…
POS Plans
POS stands for Point of Service. It’s a type of health plan that functions like an HMO when receiving in-network services (so a PCP and referrals may be required), but, unlike an HMO, it does provide some out-of-network benefits.
What are the typical costs associated with POS plans?
The costs for POS plans can vary. They usually have copayments for doctor visits and other services. There might be a deductible, especially for out-of-network care. The premiums for POS plans may be higher than HMOs but lower than PPOs, balancing between the two in terms of cost and flexibility.
Do POS plans require a Primary Care Physician (PCP) and referrals?
Yes, POS plans typically require you to select a Primary Care Physician (PCP) from within the network. Your PCP is your first point of contact for all health issues and will provide referrals to specialists, whether they are in-network or out-of-network, for you to receive covered care.
How do POS plans handle out-of-network care?
POS plans provide coverage for both in-network and out-of-network care. If you choose to go outside the network, you’ll likely pay more than you would with in-network services. However, if your PCP refers you to an out-of-network provider, the plan may pay more of the cost than if you go…
What is a Point of Service (POS) plan?
A Point of Service (POS) plan is a type of health insurance that combines features of both HMO and PPO plans. Like an HMO, it requires you to designate a Primary Care Physician (PCP) and get referrals for specialist care. However, like a PPO, it offers the flexibility to seek…