Your Point of Service (POS) plan offers two options for seeking care: an HMO option and a PPO option.
Advantages of using your HMO option
When you use your HMO option, you get the most out of your POS plan benefits, and your copayments are set at the lowest amounts.
- Non-emergency physician visits are available for a fixed copayment.
- Your calendar-year copayment maximum is set at its lowest level.
- You'll rarely need to deal with claims forms.
- You won't need to satisfy a deductible.
Your Personal Physician is usually your first point of contact for your health care using your HMO option.
Under your HMO option, if you need the care of a specialist, such as a dermatologist or a cardiologist, it's your Personal Physician's role to refer you.
Learn more about working with your Personal Physician.
Flexibility of using your PPO option
When you use your PPO option, you have access to California's largest PPO network without needing a referral from your Personal Physician. You also have the flexibility to see non-preferred (non-network) providers, and when you visit a preferred provider you'll rarely need to pay for your care at the time of your visit or file claim forms.
Learn more about preferred and non-preferred providers.