What is Point of Service Health Insurance (POS) USA ?
With point-of-service
(POS) health insurance,
you have access to healthcare services at a lower overall cost, but with fewer choices. Plans vary, but generally POS plans are considered a combination of Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans. You can access care services from providers and facilities on or off your network, but your coverage is greater if you stay on the network. If you have a point-of-care plan, depending on the specifics of your plan, you may be asked to obtain referrals from your Primary Care Provider (PCP).
What does "service point" mean?
The term “service point” means the location and provider
from which you receive services. Your coverage will vary depending on whether
you use an on-network or off-network provider and whether you have received a
referral if your plan requires it.
How do Point of
Service plans work?
As an HMO, you first select a Primary Care Provider (PCP) to
help coordinate and manage your healthcare needs. Your service costs will be
lower when you see providers online. As a PPO, you can decide where to get
help. Your PCP can refer you to network specialists if your specific plan
requires it. You can also consult specialists outside of your network for free
without a referral, but you may have to pay more for this flexibility.
What are the
advantages of POS insurance?
Your healthcare costs tend to be lower when you use online
providers.
You can see a specialist outside the approved network and be
insured, but you can pay more out of pocket.
If you use the support and services of the network, the
formalities are usually taken care of for you.
What are the
disadvantages of POS insurance?
Depending on the plan you choose, you may need a referral
from your PCP to see network specialists.
If you seek treatment outside of your network, healthcare
costs may be higher.
If you use off-network care and services, you may be
responsible for all the paperwork involved, including managing and paying
bills.
Is all POS insurance
the same?
no. The above is a general description of traditional POS
health plans. Depending on the design of the plan and the insurer, the features
of the POS plan as well as the name of the plan may vary.
POS insurance is most
suitable if you want to meet the conditions of this type of health insurance.
If you feel comfortable choosing a PCP to manage your care, this plan could be
for you.
Keep in mind that while your POS plan costs less overall,
you may pay higher fees if you look for a provider outside of your plan's
network. It's worth checking that the providers you see are usually available
on the network for the plan you've chosen.
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