Which Is Better – POS or PPO?
If you only look at the premium cost, POS is cheaper at $56 per month or $672 per year. However, the exemption is $500 more per year as a family.
Tier 1 and 2 prescription drugs also cost more with POS, but hospital stays and outpatient surgeries cost less. The PPO has $250 per event that must be met before the money security for surgeries and hospital stays begins.
However, the PPO has the benefits of better Rehab PT/OT with a flat fee of $30 (exemption) against 20% co-security after deducting from the POS plan.
What I also find interesting is that the above PPO example does not cover OON benefits for Telemedicine, Preventive Care, Diagnostic Labs or Chiropractic Care. As you can see, not all PPOs provide OON benefits for all types of care.
That’s why you should really know your individual health plan inside and out before you sign up and receive services. Even within the same plan type and metal layer, there is much variation from one plan to the next. Always pay close attention to the little details when comparing health insurance plans.
And once again, whether you’re planning to retire early with kids or be an entrepreneur, paying the full cost of your health insurance plan is one of the big downsides.
Find a Policy That Fits Your Needs
As the side-by-side comparison of POS and PPO Gold plans shows, it really comes down to a family’s expected needs and usage to decide whether POS versus PPO above is better.
A family who anticipates a large number of hospitalizations or surgeries can save with POS even with a higher deductible cost as there is no cost per event of $250. Whereas, a family that needs a lot of physical or occupational therapy can save even more. PPO Care despite higher premium due to fixed $30 fee and waiver of exemption for Rehabilitation.
Like so many things in personal finance, finding the health insurance policy that best fits your needs is highly personal.
Things to consider include your monthly budget, amount of requests and need for flexibility, size of provider network, costs. deductions/copays/coinsurance/prescriptions, the types and frequency of services you think you need, and your overall health.
Staying With a PPO Plan
We’re staying with our current PPO plan, which will cost $80 more per month in the new year. The devil you know is better than the devil you don’t know. We now want to minimize the surprise headaches of a family and health insurance.
I’m also used to PPO plans because that’s what I’ve always had except for a few years in an EPO. My previous employer offered fully subsidized PPO health insurance (rare!) until the Financial Crisis.
However, there are POS plans as that are suitable for many people. Be sure to run different health insurance scenarios before making a decision. If you’ve bought it before, I’d love to hear your feedback on the Point of Service plans.
Related: Is It Worth Having a High Deductible Health Plan to Qualify for an HSA?
Readers, does your employer offer POS plans? If you’ve had it before, how was your experience? Was the referral requirement a PITA? Did the plan and cost structure work well for you? What type of health insurance plan are you currently using?
What plans does UCLA take?
Health insurance through your employer, HMO insurance, and POS insurance
Does Cigna offer coverage in California?
In California, Cigna offers many products, services, tools and resources to a variety of customers and individuals. Our HMO plans are offered by Cigna HealthCare of California and Network, Inc. Our Point-of-Service plans are offered by Cigna HealthCare of California, Inc.
Did UCLA get medical insurance?
Does UCLA Health accept Medi-Cal insurance? Yes _ Our hospitals support government health insurance programs – Medicare and Medi-Cal.
Do UCLA doctors accept Medicare?
UCLA Health accepts many types of health insurance.
These plans include Government health insurance programs (Medicare and Medi-Col).
What’s UC health insurance cover?
UC SHIP offers medical, pharmacy, dental, vision, mental health, and substance use disorder benefits for UC undergraduate and eligible students and their clients.
Is Cigna insurance PPO or HMO?
Cigna Health Maintenance Organization (HMO)
With the Health Care Organization (HMO) Health Council, a primary care provider can assist in coordinating care.
IT\’S THE DIFFERENCE: What is student af1?
What states does Cigna HealthSpring cover?
Where are HealthSpring customers? Mississippi, New Jersey, Pennsylvania, Tennessee, Texas, West Virginia, and Washington, DC
as well as national stand-alone prescription drug plans.
What cities does Cigna cover?
In 2020, Cigna offers individual and family health plans for exchanges for elections to counties in 10 states: Arizona, Colorado, Florida, Illinois, Kansas, Missouri, North Carolina, Tennessee, Utah and Virginia .
Does Cedar Sinai accept Medi-Cal?
What insurance plans does Cedar-Sinai accept? At Cedar-Sinai Health Care System, we believe that world-class care should be accessible to all. That is why we accept most insurance plans for private insurance, HMOs, Medicare and Medi-Cal.
How does Medi-Cal Service Fee work?
At one time most private health insurance companies and many government programs such as Medi-Cal and Medicare provide healthcare on a base “fees-for-service” (FFS) payment. This means that after the health provider pays, the provider sends a certificate to someone for a particular service.