How a POS Plan Works

A point of service plan, or POS plan, is a type of managed care health plan that combines characteristics of both the EPO and PPO.  The Exclusive Care Select plan does not require you to select a primary care physician (PCP).  This plan gives you the flexibility to choose from three levels of medical coverage. Each time you need medical care, you get to decide which of the following tiers is best for you.

Tier 1: the Exclusive Care Select network provides comprehensive coverage through Exclusive Care, a focused network of hospitals, medical groups, and physicians. 

Tier 2: the national provider network* provides excellent network coverage throughout the state, as well as coverage anywhere in the country.  This tier of coverage utilizes the Blue Shield Blue Card network of providers.

Tier 3: out-of-network providers are covered by the plan as long as they are licensed providers. Keep in mind your out-of-pocket costs will be higher, as these providers do not offer discounted rates.

The plan pays more—and your out-of-pocket costs are lower—when you receive services from providers in Tier 1 or Tier 2. Because the plan uses Exclusive Care’s provider network and a national network, you have access to thousands of doctors, hospitals, and facilities across the country.