MODULE 2

Lesson 1 - Plans

HMO-POS Health Maintenance Organization – Point Of Service

  • In-Network coverage, SOME Out-Of-Network benefits

 

  • PROS
    • Out-Of-Network for emergency / urgent care situations AND some routine care situations
    • USUALLY
      • Lower copays
      • Lower / No deductibles
        • Medical and RX
      • Higher allowance for benefits
        • Dental, Vision, Hearing, OTC
  • CONS
    • In-Network coverage MOSTLY
    • Smaller / Limited Doctor Network
    • MUST
      • Have a Primary Care Doctor assigned to the plan
      • Have a Primary Care Doctor refer them to a specialist for In Network ONLY
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