Point of Service (POS) (Part 4 of 8) — FAIRHealthConsumer.org
Автор: FAIR Health
Загружено: 2017-11-01
Просмотров: 5997
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A POS plan is a combination of an HMO and PPO. You decide whether to stay in your network or go outside of it at the time you need care (the “point of service”). With a POS plan, you select a Primary Care Physician (PCP) who coordinates your care, and refers you to specialists if needed. When you need medical attention, you visit your PCP first, and he or she can refer you either in- or out-of-network. But, if you do go out-of-network, your costs will be higher. You won’t have to pay the full cost of your care, but you’ll pay a bigger share.
There’s not much paperwork in a POS if you stay in-network. You simply pay your co-payment or co-insurance up front when you visit your doctor, and your doctor in turn sends claims right to your insurer. But, if you go out-of-network, you’ll need to pay the provider in full yourself, and then submit the claim to your insurer to be reimbursed.
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