POS Health Insurance

By: EconomyWatch Content   Date: 24 February 2010

About The Author

EconomyWatch Content

Follow The Money

EconomyWatch, Content Team

 

  • Dot Div
  •      

A Point-Of-Service or POS health insurance is a managed healthcare plan, similar to the federal government sponsored HMO plans, designed to provide access to medical aid at affordable cost.

A POS health insurance is linked to a network of healthcare providers. Like any managed healthcare plan, a POS entails choosing a primary care physician (PCP) from the network. This preferred provider must be approached for all diagnosis and treatments. If needed, the physician can refer the insured to a specialist within or outside the network. In this situation, the physician undertakes the responsibility of completing insurance paperwork on behalf of the insured.

Benefits of POS Health Insurance

A POS health insurance plan offers maximum flexibility, enabling individuals to utilize the services of healthcare providers within and outside the insurer’s network at affordable prices. Other key benefits of a POS healthcare insurance are:

  • Minimal co-payment: Similar to other government-sponsored, managed healthcare plans, the co-payments or contribution by the insured is very low.

  • No deductibles: Insurance cover under a plan typically commences after lapse of a predetermined time. This implies that if an insured undergoes a treatment during this period, s/he has to bear the entire expenses. Under a POS plan, however, the cover begins immediately and continues as long as the insured stays within the plan’s network of physicians.

Finally, a POS health insurance does not maintain gatekeepers for non-network care. In fact, the insurance holder may approach a healthcare provider outside the POS network even without consulting the primary care physician.

POS Healthcare Insurance: Important Considerations

Although, an insured covered under a POS plan can approach a provider outside its network, it is advisable to keep this option as a last resort. This is because treatment outside the network requires higher co-payments on the insurance holder’s part. This may be as much as 30-40% of the total cost of treatment.

Another vital drawback of POS health insurance is that approaching a primary care physician for obtaining a referral can be both challenging and time-consuming. Also, approaching a specialist directly, that is without the reference from PCP, typically requires the insured to pay the entire cost of treatment.


  • Dot Div
  •      

Most Popular in Health Insurance

Related Links
blog comments powered by Disqus