Advantages and Disadvantages of Point-of-Service Health Plans

Point-of-service (POS) plans are one of 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 include some features of each of these, which some people may find advantageous. Below is a breakdown of the pros and cons of a POS plan compared to other plans.

Benefits of a POS plan

  • Not deductible. One of the most obvious benefits of a POS plan is the lack of deductibles for physicians in your network. This means you don’t have to pay for your medical expenses yourself before your insurance starts paying you. PPOs, on the other hand, have their own risks.
  • Low co-payments. POS plans have lower co-payments than PPOs. If you have medical expenses, you only have to pay a small portion of it as a co-payment, and your POS plan will cover the rest of the cost.
  • More choices and freedom to choose. Unlike HMOs, POS plans offer partial coverage even for doctors who aren’t in your network. This means that if you’re unhappy with the choices available in your network for a particular medical treatment, you can see an out-of-network doctor and still have some coverage.

Disadvantages of a POS plan

  • Under a POS plan, you must choose a primary care provider (PCP). This physician acts as your primary physician for all medical needs. He or she can refer you to specialists in your network if you have a specific health problem. In order for a doctor’s visit to be covered as an in-network visit, you must go through your PCP to see a specialist.
  • If you visit an out-of-network doctor, you will only have limited coverage. You must pay a deductible and higher co-payments than with in-network physicians.

Choosing the right health insurance plan

If you’re happy with the doctors in your network and don’t mind having one primary care provider you have to go through to get coverage, then a POS plan might be ideal for you. Often a general practitioner or the specialist he or she will refer you to can cover all common medical needs. However, if you have unique medical conditions that require you to regularly visit doctors outside the POS network, you’re better off looking for a plan that covers you with those doctors.

The greater choice and freedom of physicians, lower co-payments and zero deductibles for in-network physicians make the POS an attractive option that you may want to consider. To learn more about POS health insurance and other options available to you, visit Texas health insurance company Option 1 Health’s website here.