Why An Hmo With A Point Of Service Option Can Be A Good Idea To Help Keep Health Costs Manageable
Wednesday, May 19th, 2010 by adminHealthcare costs are a concern for most people these days. But it isn’t always easy to know how best to manage these costs. While it is true that having insurance lowers your costs, it is still important to be able to navigate the health care system to understand what the best options are. One very good option to consider is a Point of Service option, which many HMOs offer. Below is an explanation of how this option works for anyone who is thinking about adding this to their policy.
What is a Point of Service option? It is an option which some HMOs provide which allows you, the consumer, greater flexibility in choosing your health care provider. This isn’t always as flexible as if you are going with a PPO, but you are retaining other benefits of an HMO. Generally, these options allow you to choose an out-of-network provider with different levels of benefit. It may be that you have to pay everything up front (without a co-pay), only to be reimbursed later. Or perhaps you can choose out-of-network providers for a restricted range of services. In any case, you get to choose how you want your insurance company to handle things at the moment of service.
Typically, a Point of Service option will cost a little more than other options. So it might seem that they are a bad idea or won’t help you keep your costs down. However, by paying a little more and gaining this flexibility, you may save more money overall. For instance, you may need a particular service quickly, or you may find yourself injured while on vacation with little time to find an in-network provider. This option will allow you to get care quickly. Or suppose you need a referral from your primary caregiver in order to obtain a service that would be considered “in network.” Having the greater flexibility of a Point of Service option will allow you to go straight to that service, without having to wait for the referral, which is not always quick to come. In effect, this option gives you greater control and can be a safeguard for those times when you simply can’t find in-network care quickly enough.
This isn’t to say that HMOs which offer this option are poor or have narrow, confining networks. But typically, the trade off that comes with very low healthcare costs is a narrower network than many of us find convenient. Being able to have access to a greater number of services and providers is never a bad thing, and in a pinch you don’t want to end up spending more than you can afford.

