What is POS and Managed Health Care Plan

POS stands for Point-of-Service. It is a type of managed healthcare plan. Other types of managed care plans such as HMO (Health Maintenance Organization) and PPO (Preferred Provider Organization) are more popular and better known to people than POS. This type of insurance plan can be called a hybrid plan or a combination of both HMO and PPO. It provides the freedom of PPO along with the low cost benefits associated with an HMO plan. In this article we will discover some of the advantages offered by the POS plan.

You will be required to choose a primary care physician (PCP) just like an HMO plan. The plan consists of a provider network and you have to choose your PCP within that network. If the doctor you want to choose is not listed there you might have to change you mind or choose another healthcare insurance plan. The PCP will become your point of service. If you need to see a specialist or another physician that is outside the network, your PCP will have to make referrals. Without a referral the insurance plan will not cover your healthcare charges. If you do get a referral from your PCP, the plan will provide some compensation for the charges you will have to pay to see that specialist. Within the network you do not have to fill any forms and do other kind of paperwork. However, outside the network you will be required to complete your file containing healthcare receipts and copies of duly filled out forms.

As compared to other managed care plans you have the maximum freedom in a POS plan. You can go outside the network freely and still get compensations provided that your PCP gives you the referral. Co-payments within the network are very low as compared to HMO or PPO and there are no deductibles. In addition to this the annual fee that you to give to the insurance company is very low. The costs of POS plan are lower than those of other plans because most of the time your PCP will choose a specialist that is inside the network and you wont have to go to see an expensive specialist.

Some of the disadvantages of a POS plan are: for non-network healthcare there are high co-payments and getting referrals for specialists might not be an easy task. In addition to this there are deductibles in case of non-network healthcare. However, the plan is overall less costly than PPO because the insurance company covers most of your visits to physicians and specialists.