There cane be a lot of confusion with Point-of-Service Plan (POS), so here are the main things you should know.This healthcare plan coverage is quite a hybrid between Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans. Just like the HMO, this plan offers you the primary care provider from its network. The difference is that POS will, just like PPO offer you a possibility to seek the help from outside your network of providers but you will be needing to pay most of those costs – unless your primary care provider referred you to that specific provider that is out of your network. So, in case of emergencies and in case of referral, your POS medical plan will pay your bill.
Most people choose either PPO or HMO plan, regardless of the fact that POS offers the best of both worlds. This is somewhat to the fact that POS plan is not marketed so aggressively as other plans. The premium you need to pay for POS is somewhere between the higher PPO premiums and lower HMO premiums.
How does POS plan works
So, in short, with POS healthcare plan you will get more of that desired freedom to choose your own health care provider, just like you can do it with HMO. There is a moderate amount of paperwork you will need to fill out if you see a provider (doctor, specialist, hospital) that is out of your POS network. You can choose your primary care doctor and he will coordinate your care through your life and will refer you to the specialists you might need. In this way, you will make a personal connection with your physician as he monitors your health through your life and is familiar with your medical history. But, you can still see any doctor you want. If that doctor is in your POS network, the charge will be covered, but if it is not, you will need to pay a little more than usual.
What you need to pay for your POS
In order for your POS to start covering your healthcare, you will be needing to pay a deductible that can be higher for providers that are out of POS network. Here you do not pay copay and coinsurance, you just need to pay one of those. Copay is paid when you receive care, and coinsurance is the percentage of the charges for your care. Percentage variates depending on the level you are (bronze, silver, gold, platinum), where the percentage you need to pay can be 40, 30, 20, or 10 percent. Of course, copay and coinsurance are higher when you use a provider that is not part of your network.