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.
Taking the Next Steps
If you’re dissatisfied with your current healthcare plan, consider changing your health insurance policy.