POS Plans in Arizona
A Point of Service plan is a highly flexible managed care option that allows the user to receive partial or full coverage whether or not they choose to use healthcare providers within the insurance company’s network. However, the user receives the most benefit when they use providers within the network. One of the most significant advantages of PPO plans lies in the fact that you do not need to choose between a network or non-network provider until you actually need the service they provide.
Wondering if a POS will cover all of your healthcare needs? Request a quote and speak with an agent.
The Benefits of POS Plans
POS plans combine some aspects of Health Maintenance Organization and Preferred Provider Organization plans. As with an HMO, there is no deductible to pay for network healthcare, but a small co-payment is required each time you use a network healthcare provider. A typical plan may require a co-payment of $10-$15 for each network provider visit. Another similarity to HMO plans is that when you enroll in a POS plan, you are required to choose a primary healthcare doctor who is a member of the insurance company’s provider network.
Your primary care doctor can refer you to specialists in or out of the network, and as long as you have a referral, the insurance company will pay the majority of the costs. However, if you self-refer to a healthcare provider that is not in the network, the POS plan resembles a PPO in that you must pay a deductible and also pay a larger co-payment. For non-network providers the co-payment is typically between 30% and 40% of the cost of the visit, and the annual deductible is usually around $300 for an individual and $600 for a family.
Which Expenses do POS Plans Cover?
POS plans typically provide coverage for the following medical expenses:
- Visits to your primary care doctor and any specialist they refer you to (whether in or out of the provider network)
- Diagnostic laboratory services
- Hospital services (including diagnostic procedures such as x-rays)
- Emergency services
- Prescription medications
- Preventative healthcare such as vaccinations and routine check-ups
- Some plans may also provide coverage for dental care
POS plans are ideal for people who want some flexibility in their healthcare coverage, with the freedom to choose any provider they need without having to cover all of the associated costs when they visit non-network providers. However, because choosing non-network providers quickly becomes expensive, these plans most benefit people who can choose network providers most of the time.
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