95.8k views
3 votes
In which plan ( HMO/POS) are out of network benefits available at a higher cost?

User Nayden
by
8.0k points

1 Answer

4 votes

Final answer:

In an HMO plan, out-of-network benefits are generally not available, while in a POS plan, they are available at a higher cost.

Step-by-step explanation:

In an HMO (Health Maintenance Organization) plan, out-of-network benefits are generally not available or are extremely limited. HMOs typically require individuals to choose healthcare providers within a network of contracted healthcare professionals and facilities. If someone requires healthcare services from a provider outside of the network, they would have to pay the full cost of the services themselves.

On the other hand, a POS (Point of Service) plan offers more flexibility when it comes to out-of-network benefits. With a POS plan, individuals have the option to receive care from out-of-network providers, but the benefits may be subject to higher costs. The insurance company will typically cover a portion of the out-of-network costs, but the individual will be responsible for a higher deductible, copayment, or coinsurance.

User Tony Miller
by
8.3k points
Welcome to QAmmunity.org, where you can ask questions and receive answers from other members of our community.

9.4m questions

12.2m answers

Categories