Plans with Out-of-network Coverage
Medicare Advantage HMO-POS (point-of-service) plans cover out-of-network hospital and specialist visits.

What is a POS plan?

POS stands for Point of Service. It is a type of Medicare Advantage HMO plan that includes out-of-network coverage for certain services. On some POS plans, the out-of-network coverage may have a different copay or coinsurance (your share of the cost) than if you go to one of our in-network providers. CarePlus plans with out-of-network coverage are labeled (HMO-POS).

Who is a good fit for this plan?

CarePlus has a large network of trusted providers, but in some areas a POS plan may give you more options beyond our network. This may help cover your care from a preferred doctor or hospital that’s not in our network. Depending on where you live, your cost for services from an out-of-network provider may be higher than those from a network provider. Or, it may be exactly the same.

Why don’t all plans provide out-of-network coverage?

In most cases, CarePlus plans require you to see in-network doctors so we can keep your costs low while providing the best possible care. But for certain plans and areas, we recognize that out-of-network coverage can help give you more options.

Please keep in mind that even if your plan is not a POS plan, all plans cover out-of-network urgent and emergency care. In the case of an emergency, please call 911 and go to your closest hospital.

Out-of-network/non-contracted providers are under no obligation to treat CarePlus members, except in emergency situations. Please call our Member Services number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.