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Does anyone know the difference between a PPO health plan and POS?

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CAH127
LIF Adult

Member since 7/07

1694 total posts

Name:

Does anyone know the difference between a PPO health plan and POS?

I currently have Empire BCBS PPO and I found out today that not only did my copays go up quite a bit, but it is switching from PPO to POS. I have no idea what the difference is and if this is worse or better. Anyone know?

Posted 1/5/09 12:48 PM
 

Blu-ize
Plan B is Now Plan A

Member since 7/05

32475 total posts

Name:
Susan

Re: Does anyone know the difference between a PPO health plan and POS?

POS plans typically have a gatekeeper. You pick a primary care doc and he/she has to refer you for tests, specialists..etc.

PPOs typically don't need referrals.

Posted 1/5/09 12:50 PM
 

LuckySV
LIF Adult

Member since 10/05

4675 total posts

Name:

Re: Does anyone know the difference between a PPO health plan and POS?

My insurance switched form Aetna PPO to POS. There have been no other changes other than they are calling it a POS. I don't need referrals and I don't have to pick a PCP. It's actually a little bizarre. What was the point of the switch?

Posted 1/5/09 1:35 PM
 

MrsSteflily
I love chocolate

Member since 4/06

2047 total posts

Name:
Stef

Re: Does anyone know the difference between a PPO health plan and POS?

We had the same switch. As far as I could tell, everything is the same except anything out of the designated area is out-of-network, except ER.

For example, a dependant in a college upstate visiting a doctor near campus would be out of network.

I checked all of our doctors and specialists and they are in-network and we don't need referrals.

Make sure you check the website.

Posted 1/5/09 2:01 PM
 

leo919
LIF Infant

Member since 1/09

119 total posts

Name:
MELISSA

Re: Does anyone know the difference between a PPO health plan and POS?

ppo usually means you do not require a referral to see a specialist. Pos means you will require a referral to see specialist. hthChat Icon

Posted 1/5/09 10:24 PM
 

MrsSteflily
I love chocolate

Member since 4/06

2047 total posts

Name:
Stef

Re: Does anyone know the difference between a PPO health plan and POS?

i found this info on Empire BCBS's website:

Direct POS:
Advantages
Visit any in-network provider without a referral from your PCP (Primary Care Physician).

No referral needed to see a network OB/GYN.

Pediatricians, internists, or family or general practitioners may be selected as your PCP.

No claim forms to file for in-network care.

In-network and out-of-network coverage.


HTH.

Posted 1/6/09 10:31 AM
 
 

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