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Q: What Is a POS Health Plan?

Asked by Anoynmous on October 13, 2017

Erica Block October 13, 2017

With POS (Point of Service) plan coverage, health insurance policyholders receive care at a lower cost when they receive care from in-network doctors, though this type of plan also includes coverage for out-of-network care (with a referral).

POS plans require policyholders to elect a primary care physician (PCP) and they must obtain a referral from their PCP before seeing a specialist – even if that specialist is in-network. In essence, POS plans offer lower medical costs in exchange for a more limited choice of providers. It’s important to note while POS plans may provide partial out-of-network coverage, it is the patient’s responsibility to pay bills and fill out necessary claim forms in order to be reimbursed for the out-of-network care they receive.

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