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Michigan-based Priority Health offers Medicare Advantage as either HMO-POS or PPO plans. Enrollees may use out-of-network providers but may have higher costs. ... UnitedHealthcare offer Medicare ...
The POS is based on a managed care foundation—lower medical costs in exchange for more limited choice. But POS health insurance does differ from other managed care plans. Enrollees in a POS plan are required to choose a primary care physician (PCP) from within the health care network; this PCP becomes their "point of service". The PCP may ...
For example, if patients stay in a network of providers and seeks a referral to use a specialist, they may have a copayment only. However, if they use an out of network provider but do not seek a referral, they will pay more. POS plans are becoming more popular because they offer more flexibility and freedom of choice than standard HMOs.
A survey issued in 2009 by America's Health Insurance Plans found that patients going to out-of-network providers are sometimes charged extremely high fees. [117] [118] Network-based plans may be either closed or open. With a closed network, enrollees' expenses are generally only covered when they go to network providers.
Check your network: If your Medicare coverage is provided through an insurance provider with a network of doctors and hospitals, check with the company to be sure your doctor is in their network ...
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