How does Aetnas Quality Point-Of-Service® program (QPOS) work?
Our Quality Point-Of-Service program covers medical expenses whether you visit an Aetna participating provider or an out-of-network doctor or hospital. You can keep your out-of-pocket expense to a minimum when you see your participating PCP for routine care, and when he or she coordinates necessary specialty or hospital care. You also have the freedom to go directly to a PCP, specialist or hospital for medically necessary care any time you wish. If you choose that route, except in the case of OB/GYN, you will be responsible for the deductible and coinsurance. You may self refer to an OB/GYN at anytime without penalty . Also, if the provider does not have a pre-negotiated contract with Aetna, except in the case of emergency you may be responsible for any amount in excess of the plan’s allowed amount up to the provider’s billed charges. Please see your benefit plan booklet for details.
