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Health Care Reform:

Health Insurance & Affordable Care Act

4 Types of Health Plans: How They Compare

Point-of-Service Plan (POS)

A POS plan blends features of an HMO with a PPO. With POS plan, you may have:

  • More freedom to choose your health care providers than you would in an HMO
  • A moderate amount of paperwork if you see out-of-network providers
  • A primary care doctor who coordinates your care and who refers you to specialists

What doctors you can see. You can see in-network providers your primary care doctor refers you to. You can see out-of-network doctors, but you'll pay more.

What you pay.

  • Premium: With a POS plan, the premium is generally lower than with a PPO plan. This is because you are required to see a primary care doctor to coordinate your care and to refer you to specialists, just like with an HMO.
  • Deductible: You pay a higher deductible if you see an out-of-network provider.
  • Copays or coinsurance: Your coinsurance is higher, such as 30%, if you see an out-of-network provider compared with an in-network doctor.

Paperwork involved. If you go out-of-network, you have to pay your medical bill. Then you submit a claim to your POS plan to pay you back.

High-Deductible Health Plan With or Without a Health Savings Account

You may be able to pay less for your insurance with a high-deductible health plan. With an HDHP, you may have:

  • One of these types of health plans: HMO, PPO, or POS
  • Higher out-of-pocket costs than many types of plans, but if you reach the maximum out-of-pocket amount, the plan pays 100% of your care
  • A health savings account (HSA) to help pay for your care because the money you put in savings is not taxed
  • A moderate amount of paperwork
  • To manage your own health care or use a primary care provider, depending on the plan

W hat doctors you can see . This varies depending on the type of plan -- HMO, POS, or PPO

What you pay.

  • Premium: An HDHP has the lowest premium compared to other plans.
  • Deductible: The deductible is high – between $1,250 and $6,350 for one person or between $2,500 and $12,700 for a family. Like with HMOs and PPOs, your preventive care is free, even if you haven't met the deductible.
  • Copays or coinsurance: The kind of health plan you have -- HMO, POS, or PPO -- determines which one you pay.
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