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To understand an HMO Point of Service (HMO POS) plan, you must first understand an HMO. An HMO (Health Maintenance Organization) is a plan with lower out-of-pocket expenses but less flexibility. In an HMO, you can receive care from providers that are a part of a specific network, but you are responsible for all costs if you go to a provider outside that network. The benefit of an HMO is that you pay a lower monthly premium and copayments. The disadvantages are that you have less flexibility because you are required only to see in-network providers if you want your care covered.
An HMO POS lifts some of these restrictions. Specifically, these plans may allow you to receive care out-of-network and still be covered. You will have slightly higher copayments for these out-of-network providers.
We are committed to helping you realize your health and financial goals by making you aware of all your options so that you can make the best choice for yourself and your family.
The main advantage of an HMO POS is the cost. An HMO POS will have lower monthly premiums and copayments than other plans. It has the added benefit of greater flexibility. You also generally won’t need referrals to see specialists.
The main disadvantage of an HMO POS is the same disadvantage as all other HMOs: less flexibility. While an HMO POS offers you more flexibility than a regular HMO, you still have less flexibility than if you had a different type of plan, such as a PPO.
In particular, you must have a primary care doctor. That doctor must be in-network. Additionally, you will require prior authorization for certain health services. Prior authorization requires the insurance company to pre-approve a service before you receive it.
We understand how confusing Medicare can be and how hard it is to find a plan that works best for your coverage needs. That’s why the Medicare Professionals are here to help! Set up an appointment with us today, and we will provide you with a free Medicare consultation to help you find the right plan.
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