What Is A POS Health Insurance Plan? – A POS health insurance plan fully known as a Point of Service plan is a type of insurance plan where you pay less when you visit health care providers under the plan’s network. These providers include hospitals, doctors, or any other healthcare provider that is under the plan’s network. But POS plans request you get a referral from a primary care provider before you can see a specialist.
This insurance plan is one of the types of managed-care health insurance plans that offer various benefits depending on whether an insurance holder makes use of out-of-network or in-network health care providers. This insurer puts together the features of two common health insurance plans. These two plans are the most common in every health insurance company.
These two plans are the preferred provider organization (PPO) and health maintenance organization (HMO). However, POS plans constitute a small portion of the health insurance market. Before opting for a POS health insurance scheme, you need to be aware of what it is and how it works.
How Does a POS Health Insurance Plan Work?
Point-of-service is just similar to an HMO health insurance plan. This plan requires policyholders to select an in-network primary care doctor and get a referral from this doctor if ever they need the insurance policy to cover a specialist’s services. Also, this insurance plan works like a PPO health insurance plan. This means that it also offers insurance coverage for out-of-network services but unfortunately, the policyholder will need to pay more for coverage. However, this insurance plan will make more payments for an out-of-network service if it is referred by the primary healthcare provider.
Plan Cost?
POS health insurance plan average cost for a 30-year-old is $505, for a 40-year-old $568, and $794 for a 50-year-old. However, POS Health insurance Plan costs are determined based on different factors. Some of these factors include the following:
- Location.
- Plan tier.
- Plan design.
- Age.
- Tobacco use.
- Dependents.
Using these factors, POS health insurance determines how much your health insurance policy would cost. Aside from these, your health insurance plan cost also depends on what insurer you are getting your insurance coverage from.
Advantages of A POS Health Insurance Plan?
Just like every other health insurance plan, POS health surety also has its advantages. This health insurance consists of different benefits which include nationwide coverage best for patients who travel a lot. Other advantages of the POS health insurance plan include:
- You can visit a specialist out of the plan’s network.
- The cost of your health care is lower when care is provided by in-network providers.
- Each time you receive an in-network treatment and services, the paperwork is generally covered for you.
For in-network services, policyholders do not need to pay deductibles but you will need to if it’s an out-of-network insurance. These and many more are advantages of getting a POS health insurance plan.
Disadvantage
While this plan comes with both features of HMO and PPO along with other benefits, there are still some disadvantages to it. These disadvantages include:
- If you get out-of-network service or a car, you may be liable for all the paperwork related. This paperwork includes bill payments and managing receipts.
- Your healthcare expenses would increase if you get healthcare from outside your network.
- Based on your POS health insurance plan, you may be required to get a referral from your PCP to visit an in-network healthcare provider.
Aside from all its benefits, POS health insurance plans hold a small market share. A reason why may be that this insurance plan is less aggressive than other insurance plans.
Are All POS Health Insurance Plans the Same?
All POS health surety plans are not the same, based on what health insurance scheme you get and your insurance company, POS health surety plans are different from each other. POS insurance is a good idea once you can choose the one that works best for you and if you are willing to abide by its terms. However, keep in mind that even if POS plans may have a lower insurance cost, you may need to pay more if you are visiting a healthcare provider outside your insurance plan’s network. Because of this, it is advisable to check if the provider you would be selecting is an in-network provider.
