What is a Point of Service (POS) Health Plan?
POS plans are health insurance that combines elements from an HMO and PPO.
With a POS plan, you can receive care from an in-network or out-of-network provider, but you pay less for going in-network. It’s similar to the PPO model in that respect.
Most POS plans require you to work with a primary care provider to coordinate your treatment and get a referral if you want to see a specialist. This is similar to the way an HMO works.
A Point-of-Service (POS) health plan is a type of managed care plan that combines features of health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Like an HMO, you must choose a primary care physician (PCP) who will coordinate your care. However, like a PPO, you can see doctors and hospitals outside of your network, but you will have to pay higher out-of-pocket costs if you do.
Point Of Service Health Plan
With a POS plan, you will typically have lower out-of-pocket costs if you see your PCP and use in-network providers. However, if you see a doctor or use a hospital outside of your network, you will have to pay a higher copayment or coinsurance. You may also have to pay a higher deductible if you see an out-of-network provider.
POS plans can be a good option for people who want the convenience of being able to see doctors and hospitals outside of their network, but who also want to keep their out-of-pocket costs down.
Here are some of the pros and cons of POS health plans:
Pros:
- You can see doctors and hospitals outside of your network, but you may have to pay higher out-of-pocket costs.
- You typically have lower out-of-pocket costs if you see your PCP and use in-network providers.
- You may have access to a wider range of providers than an HMO.
Cons:
- You may have to pay a higher deductible if you see an out-of-network provider.
- You may have to pay a higher copayment or coinsurance if you see an out-of-network provider.
- You may have to get a referral from your PCP to see a specialist.
If you are considering a POS health plan, it is important to compare plans from different insurance companies to find the one that best meets your needs. You should also talk to your doctor about which plan is right for you.
