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.