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eLearning Series:
Your Most Popular Insurance Questions
Answers For Health and Home
Insurance
( 50 articles
in this series )
POS Managed
Health Care: What Does It Mean?
POS
is a basic managed health care foundation in which one
can attain lower medical costs in exchange for
much more limited choices. Once you’re in a POS health care
program you will be asked to choose a primary care physician
to monitor your health care. This physician will become your
point of service within the health care network. In the event
that your primary care physician deems it necessary for you
to see another doctor or specialist, he/she may make referrals
for you outside the network but only the insurance company
will cover a percentage of the cost. The paperwork for medical
visits, which take place inside your network, is completed
for you, but if you go outside the network you are responsible
for filling out the paperwork and keeping very accurate records.
POS
does give you some advantages that some people do like. Annual out-of-pocket costs are usually very limited. In today's
world many people have limited resources set aside for medical
costs so low out-of-pocket expenses will be a plus for many
consumers. There is no deductible for network care. This is
another advantage people like a lot. With no deductible you
don't have to spend a certain amount out-of-pocket before things
start to get paid for. There is a deductible, however, if you
go outside the network for care. You aren't limited to HMO
providers only. This gives you the freedom of more choices
for your health care needs, which is something we all strive
for. Co-payments for non-network care are very high. This discourages
going outside the network and promotes using more primary care
providers in your network.
Your
actual costs will only consist of a monthly premium and
co-payment for health care services under the plan within the
POS network. If you’re still wondering which program is best
for you a PPO, a HMO, or a POS, consider some of these questions.
Are there a lot of doctors to choose from? No matter which
plan you go decide on, a good selection of doctors is something
you should consider before choosing a plan.
The
prices of the health insurance premiums could very well
be the most important question you may have. It won't do you
any good to have health insurance if you can't afford to pay
the monthly premiums. Therefore this is a subject that needs
great attention so that the right decision can be made. Coverage
is another thing that should be looked into. Different plans
have different coverage. Emergency room converge can also vary
by whatever plan you choose. Whatever plan you choose make
sure it has the coverage you’re looking for.
The
hospitals that are available to you is something many people
will rank high on their list of considerations. Having
a place where you feel comfortable and trust the value of their
service means a lot to most people. Hospitals can have a good
reputation or a bad one. That's why choosing a hospital will
play into which health care plan you choose. No one likes hospitals,
but if you are comfortable at the hospital that is covered,
it will certainly make for a more pleasant experience. So it
is important to know which hospitals are covered by your health
care plan.
Are their limits on the medical treatments and services a
certain plan offers? There's really no sense in paying for
a plan that won't let you use the services you really need.
Isn't that the main reason we buy medical insurance so that
we can use the services when we need them? Be sure a think
about the services that you are most likely to use, and be
sure to ask if those services are covered.
Consider
non-network care. This is a very important part of
any plan. Sometimes your physician may not be available. Be
sure to find out how much more you would be responsible for
paying to go outside your network and see a doctor. It can
be quite costly with some plans.
POS plans have many advantages and many disadvantages. Looking
over everything is something you must do before any decision
is made. Looking through each plan will take some time and
should always be done before you make that decision. You never
want to rush into your decision. POS plans are a little different
than the others but lower costs and out-of pocket expenses
are some good reasons for choosing a POS plan. Whatever managed
care you decide on, and the choices are many, it is important
to remember that with each plan there are good parts and bad.
You, as the consumer, must do your homework so you won't be
disappointed.
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