Individual Health Insurance
POS Health Insurance- Point-Of-Service Plans
The Point-of-Service (POS) health insuarance plan is considered the "Cadillac" of health plans and is by far the most expensive of all the types of health insurance. Due to the rising costs of health insurance, many companies have stopped offering POS plans because the number of people enrolling in this type of coverage was decreasing steadily. A POS health insurance plan combines the best parts of the other types of health insurance and provides three levels of health care to choose form. A POS medical plan combines access to comprehensive coverage and low co-payments and coinsurance through the HMO side of the plan. At the same time, it provides access to the preferred provider network through the PPO side of the plan, and even gives access to out-of-network providers.
With a POS health insurance plan, you are required to select a primary care physician, just as you do with an HMO plan. However, you are not obligated to use the services of this primary care physician. The incentive to seek treatment first from your primary care physician is that your coverage will be more comprehensive if you go through the HMO network of your primary doctor. Also, your out-of-pocket expenses will be lower because usually there is no deductible associated with treatment received through the HMO network.
The second level of coverage under a point of service health insurance plan is through the PPO network. This benefit works just like a separate PPO plan would work, and you may have to meet an annual deductible and pay a coinsurance for most covered services. Some POS plans offer set office visit co-payments when using a PPO provider, but these are typically higher than those available through the primary care physician. Under the PPO network, you may self-refer to specialists and claims will be handled by the physician or medical group on your behalf.
The third level of benefits under a POS medical plan is the access to "out-of-network" providers. Like an indemnity plan, you have the freedom under this level to go to any physician or hospital anywhere in the country. Your out-of-pocket costs will be considerably higher if you seek medical treatment under this level of the POS plan. The deductible and coinsurance are higher than the PPO level, and you may also be responsible for filing your own claims for reimbursement.
The primary purpose for choosing a Point-of-Service health insurance plan is to have the comprehensive coverage through the HMO network of your primary care physician, while also having the freedom to use any health care professional of your choosing. Therefore, it is important to make sure that the HMO network has physicians and hospitals that are conveniently located to your home or place of work. If the network is limited, or non-existent, paying the extra premium for a POS plan would not make sense. For the same reason, you will also want to make certain the PPO network also utilizes the majority of doctors and health care facilities in your area. Although a POS health insurance plan may seem like the ideal health care coverage, the monthly premium may not make financial sense.
You may need to explore several different options to find a POS health insurance plan. Start on our individual health insurance page and choose the state where the coverage will be provided.