Fair Square Medicare Wordmark

What Is a Medicare Advantage POS Plan?

Cover image
By Daniel Petkevich
May 10, 2023

Is an HMO-POS Plan Right for You?

When navigating the Medicare space, you might encounter several acronyms like HMO, PPO, POS, etc. Sometimes, it can be confusing and difficult to differentiate between these plans.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.
But, before choosing which plan best meets your needs and budget, you must understand how their coverage differs.
Let's take a closer look at Medicare Advantage POS plans, so you can decide if it aligns with your healthcare needs.

What's a Medicare Advantage POS Plan?

A Medicare Advantage POS plan, also known as the HMO-POS plan (Health Maintenance Organization-Point of Service) plan, is a health insurance plan that combines the features of both

HMOs and PPOs

(Preferred Provider Organizations).
Like an HMO, this plan usually requires you to choose a

primary care physician

(PCP) who will be the first point of contact for all your healthcare needs, and you may need a referral from your PCP to see a specialist.
However, an HMO-POS plan may offer some out-of-network benefits like a PPO. This means you can see providers outside the plan's network, but you will typically pay more out-of-pocket for these services.
For example, suppose you require specialist care under an HMO-POS plan. In that case, you'll typically need a referral from your primary care physician (PCP) before receiving coverage for the specialist's services. If the specialist is part of your network, your out-of-pocket costs will likely be lower. However, if you decide to see an out-of-network specialist, you'll be covered but will probably pay higher out-of-pocket costs for their services compared to in-network providers.

What's the Difference Between an HMO, PPO and HMO-POS Plan?

‎‎

Pros and Cons of HMO-POS Plans

HMO-POS plans may be a good option if you prefer having a primary care physician (PCP) to coordinate all aspects of your healthcare. It allows for comprehensive care coordination under the guidance of your PCP, leading to a more streamlined and personalized healthcare experience.
Additionally, Medicare HMO-POS plans can offer added convenience if you frequently travel. These plans provide access to out-of-network providers, allowing individuals to receive medical care even when away from home, ensuring peace of mind and continuity of care.
However, before zeroing in on an HMO-POS plan, let's discuss its pros and cons.

Pros of HMO-POS Plans

  • Lower premiums when compared to PPO plans
  • Provides coverage for out-of-network services
  • No deductible for in-network services

Cons of HMO-POS Plans

  • Premiums are higher than an HMO plan
  • Need referrals to see a specialist
  • Higher out-of-pocket costs for out-of-network services
  • They may include a deductible for out-of-network care
  • Additional paperwork is required when using out-of-network care — you'll have to file your claims to get reimbursement

Is a Medicare Advantage POS Plan Right for You?

A Medicare Advantage POS or HMO-POS plan offers greater flexibility than an HMO plan as it covers out-of-network care. However, you may require referrals from your primary care physician to see specialists and may face higher out-of-pocket costs when seeing providers outside your network. Additionally, these plans generally have higher premiums than HMO plans.
If you prefer a PCP and would also like the flexibility of out-of-network services, an HMO-POS plan would be a good option compared to a higher premium PPO plan.
Nevertheless, it's essential to consider all the aspects of the plan and make an informed decision. At

Fair Square Medicare

, we have assisted numerous Medicare beneficiaries in selecting a plan that fits their budget and meets their healthcare needs. If you need help understanding each plan's pros and cons, call us at 888-454-2383. We are here to help.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

Cover image
The Fair Square Bulletin: October 2023
Oct 2, 2023
Cover image
What Is a Medicare Advantage POS Plan?
May 10, 2023
alphabet_soup
How to Choose a Medigap Plan
Jan 10, 2023
Senior woman fretting in front of her laptop stock photo
How Medicare Costs Can Pile Up
Oct 11, 2022
Doctor demonstrating upper cervical spine anatomy stock photo
Does Medicare Cover Cervical Disc Replacement?
Jan 20, 2023
Cover image
Will Medicare Cover it?
Oct 3, 2023
scientist mixing chemical compounds stock image
Does Medicare Cover Compounded Medications?
Apr 4, 2023
Indianapolis skyline at night stock image
13 Best Ways for Seniors to Stay Active in Indianapolis
Mar 9, 2023
stair lift stock photo
Does Medicare Cover Stair Lifts?
Nov 18, 2022
Medicare Explained Thumbnail
Medicare Explained
Jan 3, 2022
Female physiotherapist helping elderly man in wheelchair do exercises with dumbbells at health center stock photo
What Does Medicare Cover for Stroke Patients?
Jan 20, 2023
Unrecognizable doctor holding highlighted handrawn Kidneys in hands. Medical illustration, template, science mockup. stock photo
Does Medicare Cover Nexavar?
Nov 30, 2022
Cover image
Does Medicare Cover Physicals & Blood Work?
Feb 1, 2024
Cover image
The Fair Square Bulletin: July 2023
Jul 17, 2023
Cover image
Medicare Advantage MSA Plans
May 17, 2023
Model of the lungs with the diseased part. Cancer or Ground glass opacity GGO. stock photo
Does Medicare pay for Opdivo?
Nov 23, 2022
Male doctor with his arms crossed stock image
Can Doctors Choose Not to Accept Medicare?
Dec 8, 2022
senior man reaching to his ear with jumbled letters going into the ear stock image
Does Medicare Cover Hearing Aids?
Nov 9, 2022

More of our articles

13 Best Ways for Seniors to Stay Active in Jacksonville

14 Best Ways for Seniors to Stay Active in Nashville

20 Questions to Ask Your Medicare Agent

2024 "Donut Hole" Updates

2024 Medicare Price Changes

Are Medicare Advantage Plans Bad?

Can Medicare Advantage Plans be Used Out of State?

Comparing All Medigap Plans | Chart Updated for 2023

Do All Hospitals Accept Medicare Advantage Plans?

Do Medicare Supplement Plans Cover Dental and Vision?

Does Medicare Cover a Spinal Cord Stimulator?

Does Medicare Cover Bariatric Surgery?

Does Medicare Cover Breast Implant Removal?

Does Medicare Cover Cala Trio?

Does Medicare Cover Chiropractic Visits?

Does Medicare Cover Cosmetic Surgery?

Does Medicare Cover Diabetic Eye Exams?

Does Medicare Cover Disposable Underwear?

Does Medicare Cover Flu Shots?

Does Medicare Cover Fosamax?

Does Medicare Cover Geri Chairs?

Does Medicare Cover Home Heart Monitors?

Does Medicare Cover Hypnotherapy?

Does Medicare Cover Incontinence Supplies?

Does Medicare Cover Iovera Treatment?

Does Medicare Cover Kidney Stone Removal?

Does Medicare Cover Kyphoplasty?

Does Medicare Cover Linx Surgery?

Does Medicare Cover Penile Implant Surgery?

Does Medicare Cover Qutenza?

Does Medicare Cover Service Animals?

Does Medicare Cover the Urolift Procedure?

Does Medicare Cover Urodynamic Testing?

Does Medicare Cover Xiafaxan?

Does Medicare Pay for Allergy Shots?

Does Medicare Pay for Funeral Expenses?

Explaining IRMAA on Medicare

Fair Square Client Newsletter: AEP Edition

How Can I Get a Replacement Medicare Card?

How Do Medicare Agents Get Paid?

How Does Medicare Cover Colonoscopies?

How Does Medicare Pay for Emergency Room Visits?

How Does the End of the COVID-19 Public Health Emergency Affect Your Medicare?

How Much Does Medicare Part B Cost in 2023?

How to Become a Medicare Agent

How to Deduct Medicare Expenses from Your Taxes

How Your Employer Insurance and Medicare Work Together

Is Botox Covered by Medicare?

Is Emsella Covered by Medicare?

Is Fair Square Medicare Legitimate?

Is Gainswave Covered by Medicare?

Is HIFU Covered by Medicare?

Is PAE Covered by Medicare?

Is the Shingles Vaccine Covered by Medicare?

Medicare Advantage Plans for Disabled People Under 65

Medicare Savings Programs in Kansas

Medigap vs. Medicare Advantage

Saving Money with Alternative Pharmacies & Discount Programs

Seeing the Value in Fair Square

Should You Work With A Remote Medicare Agent?

The Fair Square Bulletin: August 2023

The Fair Square Bulletin: January 2024

The Fair Square Bulletin: September 2023

Top 10 Physical Therapy Clinics in San Diego

What Are Medicare Part B Excess Charges?

What If I Don't Like My Plan?

What Is the Medicare Birthday Rule in Nevada?

What You Need to Know About Creditable Coverage

What's the Difference Between HMO and PPO Plans?

Which Medigap Policies Provide Coverage for Long-Term Care?

Why You Should Keep Your Medigap Plan

Will Medicare Cover Dental Implants?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2024

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2024 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M