In a POS plan, what is typically required when using a non-HMO provider?

In a POS plan, what is typically required when using a non-HMO provider?

• A. A deductible
• B. A copayment
• C. Coinsurance
• D. A premium

Answer: (A)

When you use a non-HMO (out-of-network) provider in a POS plan, the up-front amount you must pay before the plan starts sharing costs is typically the deductible. Out-of-network services aren’t covered at the plan’s usual negotiated rate, so you’re responsible for paying the deductible first, after which the plan may apply coinsurance for remaining costs. Copayments are more associated with in-network visits, and a premium is a fixed monthly cost that you pay regardless of whether you use out-of-network services. So the deductible is the upfront cost most commonly required to access care when going outside the network.

When you use a non-HMO (out-of-network) provider in a POS plan, the up-front amount you must pay before the plan starts sharing costs is typically the deductible. Out-of-network services aren’t covered at the plan’s usual negotiated rate, so you’re responsible for paying the deductible first, after which the plan may apply coinsurance for remaining costs. Copayments are more associated with in-network visits, and a premium is a fixed monthly cost that you pay regardless of whether you use out-of-network services. So the deductible is the upfront cost most commonly required to access care when going outside the network.