What Are Point Of Sale Health Plans?

Point Of Sale (POS) Health Plans

If you need to shop for a private health plan, or even if you pick a health plan from a selection your employer gives you, it is important to understand the difference types of major medical insurance. That will help you make a good choice for you and your family. Plano de Saúde Bradesco

You have probably heard of preferred provider organizations (PPO) and health maintenance organizations (HMO) medical policies. In case you have not become familiar with the details, let me provide a quick explanation.

Health Networks

First you should understand networks. A network of medical providers consists of doctors, hospitals, and other health services that agree to join the network and conform to network rules. Some of these rules may establish prices and billing practices. In return, the health provider will get listed in the insurance company's network provider list, and this could bring them some extra business.

HMO - These may be the most restrictive kind of major medical plan. In exchange for tight controls, many costs are also controlled. Most of the time you have to visit an in-network provider in order to get your medical expenses covered. You may select a primary care doctor, and he or she will direct your health care.

The positive side of these tight restrictions should be ease of access and lower out of pocket costs. The negative side may be a lack of choices.

There may be a few exceptions to the in-network rules, and you should read the policy to understand them. A common exception may be for an emergency when it is not practical to seek a network provider. Another exception could be made for the unusual case where a network does not have a specific type of health care provider that you require. If you need a unique provider, and it is not an emergency, you should get your case cleared in advance.

PPO - A preferred provider organization also has a network of health providers. In order to get the best coverage, you must visit the network providers as you would with an HMO. However, you can still get covered if you leave the network if you accept lower coverage levels. In other words, sticking to the network will give you the lowest our of pocket costs.

POS Health Plans

A point of sale plan is a hybrid HMO plan. You may still have a primary care doctor, and a network. In this way, it is very similar to an HMO. However, you still may be covered if you leave the network, but you have to accept lower coverage levels. In this way, a POS is similar to a PPO.

With a POS plan, the more control you give to your network and insurance company, the less you will pay. However, you are still allowed to decide you need to get services outside of the network,. You just have to pay more.

Is A PPO, HMO, or POS Best?

I cannot tell you which type of plan is best. That all depends upon your budget, how much choice you want to retain, and also the types of plans and networks in your own city or town. A good HMO with a large and diverse network may satisfy you. If you do not have access to a large HMO network, you may prefer to have more choices.