Individual or Family Health
Point Of Service Plans (POS's)
Not so much a different type of plan but more of a modified PPO or HMO, Point-of-Service Plans are also often referred to as an open-ended HMO or PPO. A POS usually has a smaller group of providers to choose from than a traditional PPO but gives the same freedom and flexibility to choose any provider within that small network. The POS plan also allows out of network care, but offers substantially lower rates to use those in the network. The POS basically offers the consumer something with a little more flexibility than a typical HMO or PPO that costs a bit more for that greater ability to choose.
Like a traditional HMO upon signing up for a POS plan, you will be required to choose a primary care physician to monitor your health
Care, and will require a referral to participating practitioners within the plan. Yet unlike an HMO you can seek care outside of the provider network, making the POS a bit like the PPO plan. When receiving care through your primary care physician, or being referred to a specialist within the network of your primary care physician, you will receive more comprehensive benefits and pay less out-of-pocket for these services. POS plans also resemble indemnity plans in that there is usually a deductible that needs to be met when using services from providers within the network and a coinsurance payment. When seeking treatment from a physician outside of the network the part you pay will be greater. So you can choose to go outside of the network but you will have to pay more for it. But for people who can afford it they like this freedom of choice that a POS provides. With a POS you are far more in control of your financial and medical decisions then in any other type of managed care plan.
Questions to ask about a POS health insurance Plan
- How many doctors and hospital are there to choose from in the HMO network?
- How many doctors and hospitals are there to choose from in the PPO network?
- How are referrals to specialists handled, both in and out of network?
- How many doctors and hospital are there to choose from in the HMO network?
- How many doctors and hospitals are there to choose from in the PPO network?
- How are referrals to specialists handled, both in and out of network?
- What health care services are covered?
- What preventive services are covered?
- Are there maximum annual benefits and limits on certain medical treatments or other services?
- How much is the health insurance premium?
- What are the co-payments for physician visits and other specific services?
- How much more will it cost to use non-network physicians?
- What is the deductible and coinsurance for non-network care?
- Is there an annual out of pocket maximum, and how does it apply to your choice of physicians?
- What health care services are covered?
- What preventive services are covered?
- Are there maximum annual benefits and limits on certain medical treatments or other services?
- How much is the health insurance premium?
- What are the co-payments for physician visits and other specific services?
- How much more will it cost to use non-network physicians?
- What is the deductible and coinsurance for non-network care?