A POS plan is a kind of Managed Care Plan which has both the benefits of having a low-costing HMO and the choices given by having a PPO. It is also known as an HMO that comes with a Point-of-Service option.
In the same way as that of an HMO, the POS plan will require you to select your general physician from within their network of professionals. This physician then becomes your point-of-service and he or she will be the one to keep track of your health and will also refer you to other health service providers in the network should the need arise. The physician under your POS plan will also be able to make a recommendation on professionals that are not in the network. But should you decide to go this way, the POS plan will simply cover a part of your bill as well as the costs that you will be shouldering will be a lot more expensive than if you had chosen someone from the network.
POS plans give you a wide selection of health care services, similar to HMOs. The services include check-ups, preventive care, and routine tests. The POS plan also includes services like inpatient as well as outpatient hospital care and procedures.
The cost of a POS plan involves a premium that you pay monthly. This is mostly lower than paying for a PPO. You also need to shell out a co-payment to pay for medical services that you have acquired from service providers in the network.
If you have an in-network service done, there is no need to file a claim report. But if you have chosen an out-of-network service provider, you will need to pay a higher rate on the co-insurance. You have to fill out the forms, send the bills to your insurance provider so that they could send payment, and you are also expected to keep track of the receipts.
POS plans are good because you have flexibility in deciding which health provider to go for. You can choose from the POS plan network or out of it. But of course, the costs are cheaper and the company will shoulder more if you get a provider from the network.
A disadvantage of getting POS plans is that you would have to get a referral from the principal provider if you require to be treated by a specialist. You have to pay for the deductibles and you get higher rates if you work with a provider outside the network.
If you enjoy having the options to choose just like with a PPO but you wish to avail of low costs just like an HMO then maybe a POS plan is right for you. Keep in mind that different health insurance plans cover medical services differently. You need to be aware of their specific policies so that you can make an informed decision on what suits you best.
After learning about the advantages and disadvantages of a PPO plan, I am sure that you can now make the right decision on what benefits you and your family the most. Getting information about good health insurance is the first step in protecting you and your loved ones.
Tags: health insurance, health insurance company, health insurance provider, point of service plan, POS, managed care plan