Point of Service (POS) Health Insurance Plans

Understanding POS insurance is not an easy task, but taking the time to learn about this type of health insurance coverage allows you to find the right plan for you. With prior knowledge, finding insurance can be much less stressful.

When you are looking through the many different types of health insurance options, it can sometimes feel a bit overwhelming.With your doctor of choice likely only accepting a certain kind of health insurance, getting the wrong policy may mean that you cannot use their services without paying for everything out-of-pocket.

Because of the monstrous cost of healthcare in the U.S., this is not really an option for many people. Wondering “What is POS insurance?” is a common question for many citizens who are interested in a different solution to complicated health network problems. Luckily, this special kind of insurance aims to make things easier for consumers who do not wish to limit their coverage in the ways that HMO and PPO plans do.

Understanding the differences between all of these coverage options will put you one step ahead, and give you the opportunity to choose the health insurance that you think is the fairest. This article will inform you of everything that you need to know about the POS program, and how you can use it to make the hectic health insurance market more tolerable.

What is a POS health insurance policy?

Known as a Point of Service plan, a POS is a form of health insurance that you can get in order to protect your financial assets if you ever need to utilize the U.S. healthcare system. Healthcare in the U.S. is expensive, and often requires going around to multiple doctors, specialists and hospitals in order to clear up any specific problems that you may have. To ease the costs of these services, you might consider getting a POS. Similarly to an Exclusive Provider Organization, a POS can be considered somewhat of a hybrid plan between the traditional HMO and PPO policies.

Related Article: PPO Insurance

When a POS plan is in effect, you can use it to get health insurance from any healthcare provider across the country, regardless of whether or not they are in your network. Much like a PPO plan, you will often be required to pay more money out-of-pocket if you do choose to utilize a doctor, specialist or hospital that is not in your network. However, much like an HMO plan, you will be required to have a primary care physician under this plan, and get referrals from them whenever you would like to visit a different doctor or specialist. Therefore, POSs can allow consumers to access the healthcare provider that they want for a relatively lower price, but only as long as they go through a slightly longer approval process.

Who is eligible for POS insurance?

POS eligibility has been designed to where nearly anyone is able to purchase this kind of insurance policy if they wish. While healthcare is extremely important to protecting your financial safety and physical health, it is still technically a choice that U.S. may decide to get or forego. If you would like to purchase a POS, you will need to:

  • Be living in the United States at the time of your purchase, and continue living in the country when your policy is used
  • Be a U.S. citizen, permanent legal resident or fulfill any one of the numerous non-citizen legal immigrant statuses
  • Not be incarcerated while planning to use health coverage.

A POS coverage policy may be a good fit if you are:

  • Willing to cooperate with your doctor’s recommendations. Having the ability to use your insurance on out-of-network specialists gives you a lot of flexibility with regards to your health, but you will have to get the permission of your primary care physician first. They may prevent your request, requiring you to pay for that specialist out-of-pocket if you still wish to see them.
  • Not looking for another doctor. If your current doctor is already within your Point of Service plan network, however, then you may not have to worry about any referrals. If you do not need to go to the doctor too frequently in a year, this plan will work well with your schedule.
  • Wanting a compromise between paying for an HMO and paying for a PPO. Different healthcare plans have varying costs, depending on a number of factors. POSs are usually much cheaper than POS plans, due to having some of the drawbacks of an HMO plan, such as the need for referrals.

Point of Service Plan Costs and Coverages

Buying POS health insurance is a great way to get the health coverage that you need, but it is critical that you are aware of how much the program will cost you in a benefit year. The first cost that you will need to familiarize yourself with is your premium. This is a monthly cost that is paid in order to maintain the ability to use your insurance. Premiums for this policy will vary, depending on the type of coverage that you get and the details of your policy. You will also need to factor in co-pays, which are paid to the healthcare service provider when you attend your appointments. While POSs do not have deductibles for in-network insurance to kick in, you will need to meet a high deductible if you choose to venture out-of-network.

POS insurance coverage has been designed for consumers who want a relatively cheap health insurance policy, but also want the freedom to go to any healthcare provider that they want to without having to worry about being turned away for having the wrong insurance. If you do not anticipate needing to travel much, or visit doctors and specialists that are outside of your network, then it may be a better idea to get an HMO or other network-specific plan.

How to Get POS Insurance Plans

Making your final POS health plan purchase can be easy and intuitive, once you have done all of the proper research into the kind of insurance that you need. As government-sanctioned healthcare plans, POS networks can be found by visiting the online healthcare marketplace. There, you can see the dozens of health insurance companies that offer this coverage, and easily compare their premium costs and coverage options. A few different factors will go into your monthly premiums with these providers, including your family size, household income and more.

Most people will need to apply for POS insurance during the “open enrollment” period, which often falls between November and December every calendar year. However, you may also be able to purchase a plan if you:

  • Were recently married
  • Recently had or adopted a child
  • Have recently moved
  • Have recently become a U.S. citizen, and more

After you have found the insurance provider and plan that are right for you, paying your monthly premiums and following the rules of your plan will allow you to go into the future with safe, reliable healthcare.

Related Article: Health Insurance for Families

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