A Point of Service Plan, or POS, is a type of managed care plan that allows members to use both in-network and out-of-network providers for their health care needs.  Coverage for services received from out-of-network providers is usually lower than that for services received from in-network providers.

Plan Features

At Arise Health Plan, we encourage members to select a Primary Care Practitioner (PCP) to coordinate their overall medical care.  A PCP is a participating provider who practices in the area of family medicine, internal medicine, pediatrics, general practice, or obstetrics/gynecology. 

If a member prefers to seek treatment from a provider who does not participate in our network, the member may see that provider without our approval at an additional cost (usually a higher coinsurance and/or deductible) to the member.

However, if a member requires health care services from a provider who does not participate in our network and there are no participating providers who can provide those services, the member’s PCP or participating specialist must submit a pre-service authorization to Arise Health Plan prior to the member seeking services from the non-participating provider in order for those services to be considered for payment at the same level as a participating provider.