Hmo/pos

Dec 4, 2015

  1. agentjhc
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    agentjhc Guru

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    I have a lady that wants another MAPD. She discovered the hard way that the plan she bought direct from the company had only 1 hospital and only docs with that hospital.

    She called about the AARP $0. Both docs in network. However, 2 of her Drugs are T4 and $95 each per month.

    CIGNA has a HMO/POS that is $55 a month and the drugs are T2 $17 each. Per Medicre.gov this plan saves her money.

    I have not sold a POS plan, what are the potential pitfalls for the client ?
     
  2. Chazm
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    Chazm Guru

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    Pos just gives them an out of network benefit for specialist usually. And at a higher cost like a PPO but you still need referrals.
     
    Chazm, Dec 4, 2015
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  3. Iwillpay
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    Iwillpay Guru

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    She can go to any doctor that will accept the plan (point of service) but she will pay more for doctors not in the network.
     
  4. agentjhc
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    Thanks. I will lay out both options. I wantednto make sure I wouldn't mess her up. Her PCP, or the one she wants to change to isn't in network for POS. I am certain. I need to cross sell at some point with FE, cat pee city.
     
  5. JimmyUt
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    What are the two expensive drugs. If they are pain meds or zolpidem with UHC, you can get them cheaper without the insurance many times.
     
    JimmyUt, Dec 5, 2015
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  6. MedicareAgent
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    check goodrx.com for price of drugs.