| Point of Service (POS) insurance plans are a | | | | appropriate referrals. Having to request a referral from |
| combination of the benefits you would receive from a | | | | a PCP is an additional step in accessing needed POS |
| PPO or HMO. POS insurance does not usually involve | | | | medical services. You can always skip this step by |
| deductibles. Like an HMO, POS programs require you | | | | seeing someone outside the POS network, but doing |
| to have a Primary Care Physician (PCP) who acts as | | | | so can prove quite costly. |
| your point of service for all other medical needs. The | | | | A benefit of PCP referrals is that the PCP can refer |
| PCP that you choose under a POS plan then refers | | | | you to a doctor outside the POS insurance network. A |
| you to specialists. A low copay usually covers fees for | | | | PCP referral outside the POS network significantly |
| services under a POS insurance plan. Depending on | | | | reduces the portion of the billing that you would be |
| the POS plan and the state you reside in, the copay | | | | responsible for. |
| cost can be anywhere from $10 to $30. | | | | Overall, POS programs allow for greater freedom of |
| Unlike an HMO, POS insurance plans allow the | | | | choice in health care options by combining the flexibility |
| customer to choose doctors and hospitals outside of | | | | of a PPO with the low cost of a HMO. POS insurance |
| the POS network. Coverage of services outside the | | | | plans can seem restrictive because they require |
| POS network is an average of 60%. Further, many | | | | referrals from a PCP in order for the POS coverage |
| POS insurance programs often require a deductible to | | | | of medical expenses to be maximal. This means that |
| be paid for services outside of the POS network. | | | | while POS insurance plans offer greater freedom of |
| Fortunately, even with deductibles, POS insurance | | | | choice, this freedom is regulated by the PCP. There is |
| plans usually have low out of pocket cost limits. The | | | | still the choice to seek service outside the POS |
| average POS out of pocket limitation is $2,400 for | | | | network, but that may incur large fees. Having a POS |
| individuals and $4000 for families. | | | | insurance plan means recognizing the balance within |
| One of the complaint people have about POS | | | | the POS plan so that you can plan for a balance in |
| services is that their PCP does not give them | | | | POS benefits and services for yourself. |