Hmo/pos

agentjhc

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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 ?
 
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 ?

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.
 
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 ?

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.
 
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.
 
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.

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.
 
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