Preferred Provider Organization (PPO) plans are among the most common individual and family plans in the insurance industry. These plans have no limit, and one can get medical attention from different in-network health providers without requiring a transfer or referral from the primary caregiver. Members of a given PPO plan get advice to consider visiting their insurance agency’s doctors’ network without restraint to go to a primary doctor. As such, this type of coverage refers to as portable PPO coverage. However, the problem is that in-network services get catered extensively compared to off-network services. Additionally, a person who wishes to use the off-network healthcare providers will need to have a co-payment plan ranging from $20 to $50 depending on the insurance company’s policies.
There is also what is called a Point of Service plan (POS). However, this kind of plan is not as flexible as the Preferred Provider Organization plan though the cost is relatively lower compared to that of PPO. In POS, members are not at liberty to choose out of the primary network, and as such, their choices of healthcare service providers are limited to what the insurance company has outlined.
Differences between PPO and POS
In terms of comparisons, it is essential to know the exact aspects that set them apart since these two insurance plans portray a more comprehensive array of similarities. Once one can recognize their differences, they can make an informed decision on which coverage best suits their needs. Different people have different tastes and preferences, and as such, one may get satisfaction from the services of a given health practitioner that is not covered by their insurance policy. Therefore information concerning the various insurance plans can save someone from being lured into something that will not comprehensively satisfy them.
Below are some features that may differ between a PPO and a POS plan:
- In POS, there are no deductibles, co-pays, or co-insurance that is incurred by PPO members.
- POS encourages its members to visit Primary Care Providers (PCP), which is not the case for PPO members. In PPO, though the members are encouraged to visit on-network caregivers, they are at liberty to see even those in off-network.
- In terms of referrals, PPO members do not need referrals to visit off-network physicians or healthcare providers. However, in POS, every participant must get a PCT referral to visit an out-of-network care provider.
PPO or POS?
Everyone will have their views concerning which plan is the most effective. This will depend on their needs and financial capacity at the given time. However, if one is looking to have the most flexible plan with several options, PPO “portable PPO coverage,” is best. If the cost of PPO is high, then going for POS will be pocket-friendly. However, the limitation is that there is no visiting the off-network care providers; one has to stick to the in-network PCP. Though it could be possible to get a referral from the PCP to go off-network, this occurs in rare cases.