POS - Point of Service Plan

POS plans, or Point of Service Plans, are based on the basic managed care principles: lower medical costs in exchange for more limited choice. But POS health insurance does differ from other managed care plans.

When you enroll in a POS plan, you are required to choose a primary care physician to monitor your health care. This primary care physician must be chosen from within the health insurance companies health care network, and becomes your "point of service".

The primary POS physician may then make referrals - even outside the network, in which case your benefits will be less than if a network doctor was used.

For medical visits within the health care network, paperwork is completed for you. If you choose to go outside the network, it is your responsibility to fill out the forms, send bills in for payment, and keep an accurate account of health care receipts.

The costs under a POS plan is similar to that of other managed care plans. It may be slightly less costly than a PPO because the health insurance company will still regulate most of your health care but more expensive than an HMO plas as you have the felxiblity to go outside your network.

PROS

• Relatively inexpensive if you stay in network for your care although more than an HMO plan
• You can use specialists outside network assuming you accept the additional costs
• No need to receive a referral from your Primary Care Physician to see a specialist

CONS

• Paperwork is your responsibility if the care is non-network.
• Cost of treatment outside of network is more expensive.
• Co-pays are larger than with other managed care plans.
• You may need to satisfy a deductible.
  
  

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