Point-of-Service (POS)
POS health plans allow you to see high-quality in-network and out-of-network providers, with a full range of health care services. No matter which POS plan you choose, you will receive:
- 100% coverage for preventive services completed by an in-network provider
- $0 copay on preventive drugs that target common medical conditions
- Access to our 24/7/365 online clinic, MDLIVE
- Access to our RN Comprehensive Care Coordination team
- Free Nurseline 24/7/365
- Access to Hear in America
- Tobacco Cessation coverage
Aspirus Health Plan Signature Network
With a POS plan, it is recommended that each member choose a primary care practitioner (PCP) who will help coordinate overall medical care. Unlike an HMO, POS plans give you the option to see other providers without a referral at an additional cost. Some services will require review and prior authorization.
If you seek care from an out-of-network provider, the non-participating reimbursement value will apply to out-of-network providers and services. The amount the plan pays is the allowed amount for any covered service. But if an out-of-network provider charges more than the allowed amount, you may have to pay the difference.
Here’s an example: You go to an out-of-network hospital, which charges $1,500 for an overnight stay. If the allowed amount is $1,000, you may have to pay the $500 difference.
2024 POS health plans at a glance
2024 Plan Details – Contracts, Plan Summaries and Summary of Benefits and Coverage (SBCs).
POS Gold (two options)
Individual deductible
In network
$1,150 or $2,600
Out of network
$2,300 or $5,200
Individual out-of-pocket maximum
In network
$6,800 or $4,600
Out of network
$12,300 or $15,200
Family deductible
In network
$2,300 or $5,200
Out of network
$4,600 or $10,400
Family out-of-pocket maximum
In network
$13,600 or $9,200
Out of network
$24,600 or $30,400
Coinsurance
In network 20%
Out of network 50%
Office visits
$0 – $35, $70 Specialty
POS Siver (two options)
Individual deductible
In network $3,700 or $4,500
Out of network $7,400 or $9,000
Individual out-of-pocket maximum
In network $8,650 or $9,050
Out of network $17,400 or $17,000
Family deductible
In network $7,400 or $9,000
Out of network $14,800 or $18,000
Family out-of-pocket maximum
In network $17,300 or $18,100
Out of network $34,800 or $34,000
Coinsurance
In network 20% or 10%
Out of network 50% or 40%
Office visits
$0 – $45, $90 Specialty
POS HSA Gold
Individual deductible
In network $2,800
Out of network $5,600
Individual out-of-pocket maximum
In network $2,800
Out of network $11,600
Family deductible
In network $5,600
Out of network $11,200
Family out-of-pocket maximum
In network $5,600
Out of network $23,200
Coinsurance
In network 0%
Out of network 30%
Office visits
Deductible and coinsurance
POS HSA Silver (three options)
Individual deductible
In network
$3,250 or $4,300 or $5,200
Out of network
$6,500 or $8,600 or $10,400
Individual out-of-pocket maximum
In network
$7,450 or $5,300 or $5,200
Out of network
$16,500 or $18,600 or $16,400
Family deductible
In network
$6,500 or $8,600 or $10,400
Out of network
$13,000 or $17,200 or $20,800
Family out-of-pocket maximum
In network
$14,900 or $10,600 or $10,400
Out of network
$33,000 or $37,200 or $32,800
Coinsurance
In network
20% or 20% or 0%
Out of network
50% or 50% or 30%
Office visits
Deductible and coinsurance
POS HSA Bronze (two options)
Individual deductible
In network $6,200 or $7,200
Out of network $12,400 or $14,400
Individual out-of-pocket maximum
In network $7,200
Out of network $22,400 or $20,400
Family deductible
In network $12,400 or $14,400
Out of network $24,800 or $28,800
Family out-of-pocket maximum
In network $14,400
Out of network $44,800 or $40,800
Coinsurance
In network 30% or 0%
Out of network 50% or 30%
Office visits
Deductible and coinsurance