Costs of POS Plans

If you hate being limited by “either or” situations, then you may enjoy the flexibility that is standard in a POS (point of service) managed health insurance plan. POS plans allow their members access to a team of skilled physicians at a nominal charge as well as allowing members the flexibility to choose care providers not associated with the POS network. It is a type of hybrid medical insurance plan, and the cost of POS plans vary from provider to provider.

Point of Service Premiums

Like all types of medical insurance, there will be some type of monthly cost associated with a POS plan in the form a premium payment. The cost of a POS plan is considered moderate. Because members must choose their primary physician from within the network, that helps reduce some of the overall costs of the plan. However, since the POS plan grants members the flexibility to choose their own out of network physicians, the POS network cannot control those costs and thus charge more for their premiums to mitigate their expenses.

When a member chooses to seek the medical advice of their primary physician or an in network doctor, the costs are nominal and are in the form of a reasonable co-payment. Because these doctors are in the POS system, the insurance provider can control and better estimate the expenses that may be incurred from general office visits and procedures.

Out of Network Care More Expensive

When a member opts to go out of plan for their medical care, they will pay more. The costs for this portion of a POS plan will be greater for two reasons:

  1. Members will typically have to meet a deductible (ranging from approximately $300-$600) before their co-payment will kick in
  2. For out of network medical care, the insurance company may only pay from 60%-70% of the services billed, leaving the remainder for the policyholder to pay

Since the price of health care fluctuates from area to area, it is difficult to further isolate the costs of a POS plan. It is important to contact your insurance provider and ask them to provide you with any information they may have so you can properly organize your budget and compare health insurance rates.