A Point of Service plan, or POS, is a health plan that uses certain doctors and hospitals, called your POS provider network. A POS plan has a lower premium than a PPO plan, but still provides options for choosing health care providers. These added choices may give you more flexibility when you need care. Show POS plan features:
Is a POS Right for You?When shopping for a health plan for you and your family, ask these questions to see if a POS may be right for you:
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A POS health plan stands for "point of service" and is a mix between an HMO and a PPO-style health insurance policy. With a POS health plan, you have more choices than with an HMO. You may need to select a primary care provider and need a referral to see a specialist. But with a POS plan you have the choice to use doctors, hospitals, and other providers that are not in your health plan's network. However, you will have to pay more for using out-of-network providers.
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Home Knowledge CenterPPO vs. POS Plans: What’s the Difference?
In general, the biggest difference between PPO vs. POS plans is flexibility. A PPO, or Preferred Provider Organization, offers a lot of flexibility to see the doctors you want, at a higher cost. POS, or Point of Service plans , have lower costs, but with fewer choices. There are many more details you'll want to compare, as well. PPO vs. POS: What are the main differences?When you're comparing health plans it's important to understand what sets them apart from one another. This way you can make a decision based on your needs. Here are some main features that you can compare to find out what makes a PPO different from a POS:
Comparing costs between PPO and POSWhen it comes to the costs for PPO vs. POS plans, how do they stack up?
Some health plans require you to choose a Primary Care Provider. A PCP can serve as a home base for care. They get to know you and your health needs and can coordinate care with other specialists when needed.
Do you have to see doctors in a network with a PPO vs. POS plan?A network is made up of doctors and facilities that contract with an insurance provider. Network providers typically agree to offer discounted rates to customers, which is the advantage to staying in-network. Some plans require you to see providers in a network.
Should you choose a PPO or POS plan?Which plan you choose depends on what best meets your needs.
Before choosing any health plan, make sure to review the details of coverage. These are high-level descriptions of PPO vs. POS plans. Plans can vary widely between insurance carriers and those you may purchase on your own from the Health Insurance Marketplace .
How to Shop the Health Insurance Marketplace Copays, Deductibles, and Coinsurance What is Point of Service (POS) Health Insurance?
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Home Knowledge CenterWhat is Point of Service (POS) Insurance?
A Point of Service (POS) health insurance plan provides access to health care services at a lower overall cost, but with fewer choices. Plans may vary, but in general, POS plans are considered a combination of Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans. You can access care from in-network or out-of-network providers and facilities, but your level of coverage will be better when you stay in-network. If you have a point of service plan, depending on your specific plan design, you may be required to get referrals from your Primary Care Provider (PCP). What does “point of service” mean?The term "point of service" refers to where and from what provider you receive services. Your coverage varies depending on whether you see a provider who’s in- or out-of-network and if you’ve received a referral, if required by your plan. How do point of service plans work?Like an HMO, you start by selecting a Primary Care Provider (PCP) to help coordinate and manage your health care needs. Your costs for care will be lower if you see in-network providers. Like a PPO, you have choices about where to receive care. Your PCP may refer you to in-network specialists, if your particular plan requires it. You are also free to see out-of-network specialists, without a referral, but you could pay more for that flexibility.
No. The above is a generic description of traditional POS health plans. Depending on the plan design and the insurance provider, the features of a POS plan may differ, as well as plan name. POS insurance works best if you’re willing to follow the terms of this type of health plan. If you’re comfortable selecting a PCP to manage your care, this plan may be right for you. Remember, even though a POS plan might have an overall lower cost, you may pay higher costs if you need to see a provider that’s outside your plan’s network. It’s worth checking to make sure the providers you normally see are in-network for the plan you’re choosing.
How to Shop the Health Insurance Marketplace Copays, Deductibles, and Coinsurance Buying Health Insurance: How to Choose the Right Plan Preferred Provider Organization (PPO) vs. Point of Service (POS) Plans
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