What Are Point Of Sale Health Policies?
You have already probably heard a lot about HMO and PPO health insurance
. These health plans have been around for decades. A lot of consumers are quite familiar with them. Today, a new type of health plan is becoming a little more popular. It is called a point of sale (POS) medical plan. While it looks similar to the older plans, there are some important differences you should understand for yourself.
A few years ago, you may have just had to choose between PPO or HMO health insurance. Let me describe these quickly, and this may help you comprehend the features and benefits of the newer plan type.
HMO medical insurance came out quite a few years ago. These plans required members to use a network of medical providers in order to get health services covered by the insurer. Some of these HMO plans worked very well because they provided easy access to medical providers, simplified payments, and cost control. On the other hand, they were very restrictiive. Most of the time, out-of-network health services would not be covered by the HMO. Companies may have paid a non-network bill for emergency treatment, but some people got stuck with big bills because they did not follow the rules.
In addition, plan members would have to pick a primary care doctor. This doctor would manage care for the patient. To access other doctors, the patient would have to go through their primary care doctor, though they may able to change this designation at certain times.
PPO medical plans have also been around for awhile. They are less restrictive than HMO plans.. They had a network too. Plan members would enjoy the best level of coverage by using these plan providers. The plan customers could visit an out-of-network provider. They just had to accept a lower coverage level. Things like co-payments and deductibles would be much higher for non-network services, but they may still be covered. In addition,
PPO plans did not usually require a member to name a primary care doctor. A plan member may choose any doctors they wanted to. If a plan member wanted to see a specialist, he or she was usually free to seek an appointment on their own.
POS plans are new, and they try to take adavantage of some of the features and benefits of both types of plans. They work a lot like an HMO, most of the time. In addition to sticking to a list of plan providers, plan participants might also need to have a designated primary care doctor. Still, plan participants had the freedom to use their benefits to help pay for non-network services. They just had to accept a lower benefit level.
This new type of solution may provide some real advantages for people who are usually happy with the cost savings and management of their HMO plan, but who want to keep their options open in the future. This makes it a lot simple and easier to pick an in-network or out-of-network health service. If the patient stays with the plan providers, they can enjoy lower costs. If they decide to find their own provider, who does not belong to the plan, they may pay more for their choice.
Now that you have another option, you may have to decide if a PPO, HSA, or POS plan is best.
I cannot tell you which kind of health plan you should pick. So much depends on the plans that are sold in the area, the family's budget, and the way they prefer to get their medical services. Do you need a medical policy? It is usually a good idea to shop around for a variety of choices!
by: Marilyn Katz
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