Advantages and Disadvantages of Point-of-Service Health Plans

Point-of-Service (POS) plans are one of the many health insurance options available to you and your family. A unique type of health plan, POS plans can be considered a hybrid of HMO and PPO plans. POS plans contain some characteristics of each of these, which some people may find advantageous. Below is a rundown of the advantages and disadvantages of a POS plan compared to other plans.

Advantages of a POS Plan

• No deductible. One of the most obvious advantages of a POS plan is its lack of deductibles for physicians in your network. This means that you do not have to make any payments towards your medical expenses on your own before your insurance begins to reimburse you. PPOs, on the other hand, have deductibles.
• Low co-payments. POS plans have lower co-pays than PPOs. When you have a medical expense, you will only have to pay for a small portion of it as a co-pay, and your POS plan will cover the remainder of the cost.
• More choices and freedom to choose. Unlike HMOs, POS plans provide partial coverage even for doctors that are not within your network. This means that if you are not satisfied with the choices available in your network for a certain medical treatment, you can see a doctor out of network and still have some coverage.

Disadvantages of a POS Plan

• Under a POS plan, you must choose a primary care provider (PCP). This physician serves as your primary doctor for all medical needs. He or she can refer you to specialists in your network if you have a specific health concern. In order for a doctor’s visit to be covered as an in-network visit, you must go through your PCP to see a specialist.
• If you visit an out-of-network physician, your only have limited coverage. You must pay a deductible and higher co-payments than you would with in-network physicians.

Choosing the Right Health Insurance Plan

If you are happy with the doctors that are in your network and do not mind having one primary care provider that you must go through to receive coverage, then a POS plan may be ideal for you. Often a PCP or the specialists he or she refers you to can cover all common medical needs. However, if you have unique medical conditions that will require you to frequently visit doctors outside of the POS network, you may be better off finding a plan that covers you with those doctors instead.

The greater choice and freedom of doctors, lower co-payments, and zero deductible for in-network physicians make the POS an attractive option that you may want to consider. For more information on POS health insurance plans and other options that are available to you, please visit the website of Texas health insurance company Option 1 Health here.