A Point of Service health plan offers members the option to either coordinate care through a Primary Care Physician (PCP) or seek medical care from another (out-of-network) provider.
To exercise the first option, the patient selects a PCP to manage all in-network care. The patient is usually responsible for a co-payment or coinsurance percentage for treatment.
For more choice, the patient may choose to receive care from outside the health plan’s network of physicians and hospitals without coordination through a PCP. Again, the patient is responsible for deductibles, co-payments, and coinsurance and higher costs for going out of network.