Point
of Service Plans
A Point of Service
Health Insurance Plan is a combination of an HMO and a
PPO. They offer flexibility in choosing doctors. An
insured is encouraged to use doctors within a network,
however, it is not required as it is in an HMO.
Out-of-pocket expenses are normally higher for out of
network providers. Out of network doctors will also
require a deductible.
Your primary care
physician makes a referral to a specialist, however,
the specialists can be either in or out of the
network.
The advantages
of a POS insurance plan:
- The
insured has more freedom in choosing doctors.
- For
in-network doctors, the co-payment is normally
low.
- For
in-network doctors, there is normally no
deductible
- There
is a limit to out-of-pocket expenses
The
disadvantages of a POS plan:
- If
you choose out-of-network care, there may be a
deductible and higher co-payments.
- For
in-network care, the PCP must provide a referral
- For
in-network care, the PCP must approve of
specialist care or medical tests.
By Eileen Bailey
See
also:
Understanding
Health Insurance
Major Medical
Health Insurance
Health Maintenance
Organization (HMO)
PPO Preferred
Provider Organizations
Health Insurance
Terminology
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