Defining Point of Service (POS) Health Insurance

A POS or Point of Service plan is kind of like an HMO and PPO
combined type health care plan. You have more flexibility than a
regular HMO, but pay a smaller fee and deducible than a PPO. It is
perfect for those people who need more flexibility but want to pay
less. You will be asked to select a general provider that is off
the list of acceptable doctors. This will be your primary care
physician and he or she will be the one to manage what care you
receive. He or she will direct you to specialist and hospitals as
needed that are also participants in the plan. Usually there are
many providers from each specialization to choose from and
typically covers a wide geographic area. With this type of policy,
you will not have a large deducible if any, and still have a
minimal co-pay on visits and prescriptions. Of course, this is if
you stick with the preferred providers list. You also may want to
make sure what drugs are covered under this plan and if you have to
pay more for newer on not generic medications. Some doctors don’t
think about what kind of insurance you have when writing out the
prescription and you need to remind him or her if you are only
allowed to buy generic to be covered.

You will also have a choice to see out-of-network providers when
you need a specialist and they are not on the list. Most POS plans
require you get a doctor’s referral prior to seeing another doctor
or specialist. Once referred to a specialist within the network,
you will have to be prepared to pay more. If you choose to do this,
you will be billed directly and must submit the claim to the
insurance company your self. Your insurance company will pay their
flat rate for whatever you had done and you will be responsible for
the rest. You may also be responsible at the time of service to pay
the entire amount and wait to be reimbursed your self from your
insurance. If you chose to see a specialist on you own, the cost
will be higher and around 50% if you were not referred. You will be
required to pay a higher amount if you go out-of-network. So in
essence, you have the right to see whom you chose, but at your own
expense. The POS plan will only pay their flat rate for specific
medical issues and not above it, unless it is an emergency
situation. Many people like the idea of having more say in their
health care choices, while others care more about saving money and
don’t care who they go to. What you chose will depend on what you
personally want and what is more important.

The emphasis on this plan is prevention of illness or disease to
cut the cost to both the individual and the insurer. Most other
plans such as HMOs and PPOs have the same basic emphasis. You are
encouraged to take an active roll in your health and do what it
takes to remain not sick and disease free for as long as possible.
The idea is to see the doctor less so both you and your carrier
together spends less money. The idea with this plan is that if you
have to put more money into your health care you will think twice
at whether or not you really need to go. If you want to waist the
insurance companies money you have to waist your own too to do it.
Medical insurance companies are in business to make money, they
want you to stay healthy so they can collect your premium and not
have to pay it out to the health care provider. So, for those
people who do not want to pay as high as a monthly premium tends to
opt for this type of health insurance plan. This one will ensure a
low rate with out having to worry about huge deductibles or co-pays
if used more like an HMO. So, if you think that this sound like
something you are interested in, talk to several different
companies and get some policies to look at. Make sure to look at
what is covered as well as the price. Do a little research in the
various insurance policies that are available. The one that you
need to pick will depend on your priorities.

Find out more about Defining Point of Service Health Insurance

DISCLAIMER: This information is for educational and informational
purposes only. The content is not intended to be a substitute for
professional advice. Always seek the advice of a licensed Insurance
Agent or Broker with any questions you may have regarding any
Insurance Matter.

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