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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 a few features of each of these, which some people may find advantageous. Below is a summary of the advantages and disadvantages of a POS plan compared to other plans.

Advantages of a POS plan

  • Non deductible. One of the most obvious advantages of a POS plan is the lack of deductibles for the doctors in its network. This means that you do not have to make any payments for your medical expenses on your own before your insurance begins to reimburse you. PPOs, on the other hand, have deductibles.
  • Low copays. POS plans have lower copays than PPOs. When you have a medical expense, you will only have to pay a small part of it as a copayment and your POS plan will cover the rest of the cost.
  • More options and freedom to choose. Unlike HMOs, POS plans provide partial coverage even for doctors who are not in their network. This means that if you are not satisfied with the options available in your network for a certain medical treatment, you can see an out-of-network doctor and still have some coverage.

Disadvantages of a POS plan

  • In a POS plan, you must choose a Primary Care Provider (PCP). This doctor acts as your GP for all medical needs. He or she can refer you to specialists in their network if you have a specific health problem. For a doctor visit to be covered as an in-network visit, you must see your PCP to see a specialist.
  • If you visit an out-of-network doctor, your coverage is limited. You must pay a higher deductible and copayments than you would with network doctors.

Choosing the right health insurance plan

If you are satisfied with the doctors that are in your network and you don’t mind having a primary care provider that you have to go through to receive coverage, then a POS plan may be ideal for you. Often times, a PCP or the specialists they refer you to can cover all of your common medical needs. However, if you have unique medical conditions that will require you to frequently visit doctors outside of the POS network, you’d better find a plan that covers you with those doctors.

Greater choice and freedom for physicians, lower copays, and zero deductible for in-network physicians make the POS an attractive option that you may want to consider. To learn more about the POS health insurance plans and other options that are available to you, visit the Texas Option 1 Health health insurance company website here.

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