What Is A Point Of Service Health Insurance Plan?

By Cathy Wilson Posted in Health Insurance News

A point of service health insurance plan is an insurance plan best described as a combination of a HMO and PPO plan. Typically, point of service plans have small co-payments and no deductibles. A co-payment is a small fee charged by the health care provider at the time that the medical care is administered. A deductible is an initial out-of-pocket expense that the policyholder must cover before the insurance company pays out any money.

Similarities Between POS And HMO Health Plans

With a point-of-service plan there are designated health care providers that policyholders are able to visit. Also, with this type of plan you must have a primary health care physician. If you ever need to see a specialist, you have to obtain a referral from your primary health care physician before your insurance will agree to cover the visit. All of these aspects of a point of service plan are similar to a HMO health insurance plan.

Similarities Between POS And PPO Health Plans

Like a PPO health plan, with a point of service plan you have the option to seek medical care from a provider that is not in the pre-approved network. However, the coverage offered by the insurance company for seeing an out of network heath care provider is limited, and will require more out of pocket expense from you. When getting care out of network the insurance company will require a co-payment and deductible be met before covering the medical expenses. This part of a point of service plan is most like a traditional PPO health plan.

A point of service health insurance plan has many benefits. This type of plan offers the policyholder the freedom to seek medical care from any provider they choose. Although out of network care will not be fully covered, part of the expense will be reimbursed, which is more than a traditional HMO plan will cover. If you do choose to get care from a pre-approved doctor or hospital you do not have to meet a deductible, and your co-payment will me much less than would be common for a PPO plan.

Related posts:

  1. What Does A Fee For Service Health Insurance Plan Entail?
  2. What Is A Managed Care Health Insurance Plan?
  3. What Is A Network Based Health Insurance Plan?
  4. What Does A Non-network Health Insurance Plan Do And Mean?
  5. What Is Health Insurance?

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