POS Schedule of Benefits
POS Complete Benefit Description

*The 2010 Schedule of Benefits and 2010 Complete Benefits Description will be posted as soon as they become available.

The HUGHP POS plan provides the same level of coverage as the HMO plan, but affords members the opportunity for greater flexibility to seek care:

• Without a referral from your Primary Care Physician (PCP), or
• From a physician or hospital that does not participate in the HUGHP network.

The HUGHP plan has always offered convenient access to adult primary care through Harvard University Health Services (HUHS) at four sites across the University, as well as pediatric care at HUHS in Holyoke Center. Our partnership with Atrius Health's five medical group practices allows you and each family member to select from among hundreds of PCPs in 29 new locations. All HUGHP group practices have extended hours, lab and X-ray services on site, plus access to many specialists across Massachusetts.

Your PCP will coordinate all of your care and refer you to a specialist when needed; these services will be covered as they are under the HMO plan. However, if you choose to arrange care without a referral, or choose a provider who does not participate in the HUGHP network, you will have higher out-of-pocket costs:

• You pay a $500 deductible per member in each calendar year ($2,000 family limit).
• After meeting your deductible, you pay 20% of the remaining covered charges. This is your co-insurance.
• Your out-of-network provider may bill you the difference between his or her charge for services and the amount the HUGHP POS pays for those particular services.
• You are protected by an out-of-pocket maximum. Your co-insurance annual out-of-pocket maximum is $2,000 ($5,000 family limit). Keep in mind, the out-of-pocket maximum does not include amounts you pay toward your annual deductible. When you reach your out-of-pocket maximum, most covered services will be paid in full. 

The HUGHP plan offers a wide range of preventive and specialty medical services including:

• Routine office visits and screenings
• Annual checkups
• Annual gynecological visits
• Immunizations for infants and children
• A prescription drug benefit
• Hospitalizations
• World-wide emergency coverage