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June 19 2008

Point Of Service Health Care Plan

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The third health care plan in the U.S. is the Point of Service Plan, or POS. The POS plan is a combination of HMO and PPO plans. POS requires that patients pick a primary care physician that is in their network. If a patient chooses to go to a doctor outside of the network the patient will have to cover the majority of the cost. The plan will cover a minimal amount of the outside cost, but the patient is responsible for a large portion of it. The POS plan also requires that patients get a referral to see a specialist. If a patient is referred to a doctor outside of their network, the plan will cover the cost.

Some larger companies offer their employees a choice in what plan they would like. Many times small company’s can not afford to offer their employees the choice of plan.

Whether you choose a HMO, PPO or POS depends greatly on if your doctor of choice is part of their network. If the HMO that is being offered does include your doctor, please remember that the network can change. While your doctor may be on the list this year, next year he or she may not.

June 15 2008

Preferred Provider Organization (PPO)

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Preferred Provider Organization or PPO, is another prevalent health care plan in the United States. The PPO plan is a lot like the HMO plan but there are a few distinct differences.

With the PPO plan you are not required to pick a primary care physician. You are able to see any doctor that you choose. There is a list of doctors that are in the network and you are strongly encouraged to see someone from that list however it is not required. If you decide to see a physician in the network it will most likely be less expensive. For example your plan my only cover 65% of the cost if you see a physician outside the network compared with covering 95% of the cost if you see a physician in the network. You also do not have to go through the referral process to see a specialist. The largest draw back to the PPO plan is the deductible and many times the higher co pay. HMO’s tend to keep their co pays fairly low however you don’t have the option of seeing the physician of your choice. PPO offer much more options, but those options might come at a higher cost to you.