WHAT POINT OF SERVICE PLAN (POS) IS ALL ABOUT

November 26, 2018

POINT OF SERVICE PLAN (POS): DEFINITION


POINT OF SERVICE PLAN (POS)This plan is similar to the health maintenance organization HMO in more ways because it also requires a primary care provider to be chosen and all care and referrals come to the primary care provider (PCP). Care is closely coordinated and does not require pre-authorized from the insurance company. The primary difference with the Point of Service Plan  (point of service provider) is that provides outside the network may be covered, although at a significant higher cost to the patient.

A Point Of Service Plan (POS) can be a good choice for those who travel a lot and are concerned about needing care outside the local area, or who cannot locate an HMO that carries all of their providers.

In more understanding terms, point of service plan is a type of managed care health insurance plan in the United State. It combines characteristics of the health maintenance organization (HMO) and the preferred provider organization plan.


How do a POS plan work?

POS combines elements of both HMO and PPO plans (preferred provider organization). Like and HMO plan, you may be required to designate a primary care physician who will then make referrals to network specialist when needed. Depending upon the plan, services rendered by your personal care provider are typically not subject to a deductable and preventive care benefits are usually included. Like PPO plan, you may receive care from non-network providers but with greater out-of-pocket costs; you may also be responsible for co-payment, coinsurance and an annual deductible.

Benefits of POS Plan

1.   You can go out of network with relative ease because a POS is an HMO with out of network benefits. You can see any specialist. POS plans also suits people who might use lots of outpatient medical services such as counseling.

2.     You can enjoy more geographic flexibility; travelers can visit doctors nearly anywhere and still have some medical coverage.


3.    If you live in a rural area or small town, you can benefit because your choices can be less limited than with a HMO.

Take note of this: you can waste your premium money if you can sign up for POS coverage and never use out-of-network specialist. So do the mathematics each plan-considering the costs you are likely to get in return-before going into the POS route.

When planning to opt in for an HMO plan an individual should consider the cost of premium, out of pocket cost, if he has a medical condition that requires specialized care and whether having his own primary health care provider is important.

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