Using your Point of Service (POS) Plan
The POS Plan provides comprehensive health care benefits. How much we reimburse for those benefits, however, depends on how you access care. To receive maximum reimbursement for your medical care, you should follow these basic steps:
1. Choose a Primary Care Provider (PCP)
When you enroll in the POS Plan, you must choose a PCP for yourself and each member of your family.
You can think of PCPs as “total care coordinators.” They coordinate all of the care you receive--from routine preventive care to more serious medical treatment. By developing a personal, ongoing partnership with you, your PCP is able to treat you as a whole person, taking all aspects of your life into consideration. That means the care you receive is geared toward your individual health care needs.
To designate a PCP, call us at (800) 279-4000 and ask to speak with a customer service representative.
2. See your Primary Care Provider when you need medical care
You will receive the highest level of reimbursement when you receive medical services from your PCP or another Level 1 Provider. Please note, however, that services that are not covered by your policy will not be reimbursed even if your PCP recommends or provides them.
Remember, the POS Plan doesn’t limit you to seeing only your Primary Care Provider and other Level 1 Providers. You can receive care from physicians in our Level 2 Network or from non-Network providers; however, the reimbursement level will be lower.
3. Use Level 1 hospitals when you need hospitalization
The Find a Doctor feature lists the hospitals in the Level 1 Network.
Note that coverage for some services requires preauthorization by the Trust.
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| For information on what is the POS service area, please click here.
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| For more information on how your POS plan works, please click here.
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