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A POS plan offers the most freedom of the three. Like a PPO or HMO a POS plan has their network doctors. However, with a POS plan a person does not have to worry about if a doctor is in the network or not because the plan will cover all costs for doctors in or outside of the network. Only on occasion will a person have to pay a co-payment when using an outside doctor.
An HMO charges a monthly fee and provides a list of covered providers from which to choose. A person is required to choose a primary care doctor who coordinates all of their care. Most HMOs do not have co-payments or have a very low co-payment. If a person uses a doctor outside of the HMO they must pay 100% of the costs.
A PPO is a managed care plan that is set up with certain doctors who have agreed to the PPOs payment plans. The covered individual is expected to try to use providers that are within the PPO. A PPO network provider visit will cost a co-payment that is pre-set by the PPO. Using a provider outside of the PPO network means the person will have to reach a deductible and until the deductible is met they must pay all expenses out of pocket. Also providers outside of the PPO network may charge a higher price than the PPO normally pays and in this case the patient would be required to pay the difference.
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