|
SolveYourProblem
Article Series:
Health Insurance
What
is Point of Service (POS) Health Insurance?
A POS or Point of Service plan is kind of
like an HMO and PPO combined type health care plan. You
have more flexibility than a regular HMO, but pay a smaller
fee
and deducible than a PPO. It is perfect for those people who
need more flexibility but want to pay less. You will be asked
to select a general provider that is off the list of acceptable
doctors. This will be your primary care physician and he or
she will be the one to manage what care you receive. He or
she will direct you to specialist and hospitals as needed that
are also participants in the plan. Usually there are many providers
from each specialization to choose from and typically covers
a wide geographic area. With this type of policy, you will
not have a large deducible if any, and still have a minimal
co-pay on visits and prescriptions. Of course, this is if you
stick with the preferred providers list. You also may want
to make sure what drugs are covered under this plan and if
you have to pay more for newer on not generic medications.
Some doctors don’t think about what kind of insurance you have
when writing out the prescription and you need to remind him
or her if you are only allowed to buy generic to be covered.
You
will also have a choice to see out-of-network providers when you need a specialist and they are not on the list. Most
POS plans require you get a doctor’s referral prior to seeing
another doctor or specialist. Once referred to a specialist
within the network, you will have to be prepared to pay more.
If you choose to do this, you will be billed directly and must
submit the claim to the insurance company your self. Your insurance
company will pay their flat rate for whatever you had done
and you will be responsible for the rest. You may also be responsible
at the time of service to pay the entire amount and wait to
be reimbursed your self from your insurance. If you chose to
see a specialist on you own, the cost will be higher and around
50% if you were not referred. You will be required to pay a
higher amount if you go out-of-network. So in essence, you
have the right to see whom you chose, but at your own expense.
The POS plan will only pay their flat rate for specific medical
issues and not above it, unless it is an emergency situation.
Many people like the idea of having more say in their health
care choices, while others care more about saving money and
don’t care who they go to. What you chose will depend on what
you personally want and what is more important.
The
emphasis on this plan is prevention of illness or disease
to cut the cost to both the individual and the insurer. Most
other plans such as HMOs and PPOs have the same basic emphasis.
You are encouraged to take an active roll in your health and
do what it takes to remain not sick and disease free for as
long as possible. The idea is to see the doctor less so both
you and your carrier together spends less money. The idea with
this plan is that if you have to put more money into your health
care you will think twice at whether or not you really need
to go. If you want to waist the insurance companies money you
have to waist your own too to do it. Medical insurance companies
are in business to make money, they want you to stay healthy
so they can collect your premium and not have to pay it out
to the health care provider. So, for those people who do not
want to pay as high as a monthly premium tends to opt for this
type of health insurance plan. This one will ensure a low rate
with out having to worry about huge deductibles or co-pays
if used more like an HMO. So, if you think that this sound
like something you are interested in, talk to several different
companies and get some policies to look at. Make sure to look
at what is covered as well as the price. Do a little research
in the various insurance policies that are available. The one
that you need to pick will depend on your priorities. # # # # #
SolveYourProblem.com
: 2006
> Home > Health
Insurance: Main Page
|
