A POS plan is similar to a PPO in that there is a high and a low level of coverage available. However, a POS plan requires that you enroll with a single primary care physician and that a referral be provided in order to receive the higher level of coverage. A mail-order prescription program is also available. A mail-order prescription program is also available. Except for emergency situations, no coverage is available unless treatment has been coordinated by your primary care physician.
Coverage is available for the statutory periods at the employee's expense.
The group medical plan must determine the manner of coverage in consultation with the attending physician and the patient. Coverage for breast reconstruction and related services will be subject to deductibles and coinsurance amounts that are consistent with those that apply to other benefits under the plan.