Buying a health insurance is probably the most important insurance decision you will make. As you consider which plan is right for you and do your research, you ponder over many pros and cons. What kinds of care are covered in the plan? Does it cover emergency care, preventive care, surgical procedures and prescription drugs? What provisions are made for seeing specialists? How many doctors are available to choose from within the network? If at any point you are not satisfied with the answers you receive from the health plan you are considering, you should shop around to find another health plan that better fits your needs. POS health insurance can be an excellent choice if you are looking for a plan that offers variety of choice at an affordable cost.
This guide is your complete guide to POS insurance. Let us start by knowing what POS insurance is.
What is POS Insurance?
“Point of Service” (POS) is a managed health care plan. It combines characteristics of Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO). POS health insurance provides coverage within a network of health care providers at an affordable cost. In order to determine whether a POS plan is right for you, you should consider its individual features as compared to other health care plans.
What Health Care Providers Can You Visit Under Point of Service Plan?
Under the point of service plan insurance,you will be required to choose a primary care provider within a network of physicians. Your primary care provider acts as your “point of service” and should you require specialist treatment, he or she will refer you to a doctor within the network. As long as you have the referral from your primary care provider, you will be covered. Since POS insurance networks include a wide variety of care specialists, it is unlikely that you will be unable to find one that can meet your needs; however, you do still have the option to visit an out of network provider if you choose to.
What are the Costs Associated with POS Health Insurance?
Your monthly premium with POS insurance is lesser than the premiums for a PPO. In addition to the premium, you will also be required to make a co-payment at the time of service. If you choose to see a doctor outside the network, you will have a deductible to meet before you receive coverage. Additionally, your co-payment will be significantly higher for using an out of network provider than it would be if you remained within the network. The responsibility for filing insurance claims for out of network service rests with you as the patient. You’ll need to keep track of all bills and receipts and send in the forms to the insurance company. If you remain within the network, all filing paperwork will be taken care of for you.
What are the Advantages and Disadvantages of POS Health Insurance?
Those who don’t know what does POS insurance mean are not aware of its advantages. One advantage of POS insurance is that you are free to choose any health care provider you feel comfortable with while still receiving some coverage; you are not limited to in network providers. In addition, costs are reasonably low for in network health care. Your annual costs are limited and co-payments are usually low.
The primary disadvantage, however, is that point of service health insurance requires a deductible and much higher co-payment for out of network service. While there is flexibility in choice of physicians, you pay for that flexibility.
Another disadvantage is that getting a referral from your primary care physician may be difficult or you may be referred to a health care provider you wouldn’t have chosen. Specialist care can make the difference between life and death in some cases, so it’s important that you feel comfortable with the variety of options available to you within the POS network.
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