Garnett-Powers & Associates Garnett-Powers & Associates

The University of Southern California Postdoctoral Scholar Benefit Program

Information Regarding Seeking Services In- and Out-of-Network

It’s important to understand that anytime you access the out-of-network benefit on the medical Point of Service (POS) plan, you will pay substantially more out-of-pocket. That is due to there not being any contractual agreement between the insurance carrier and the medical provider to offer services at a discounted rate.

When you seek services in-network, you are accessing physicians and facilities that have agreed to provide services per the provider network discounts outlined in their contracts with the insurance carriers. When you pay 10% for your services in-network on the medical POS plan, you are paying 10% of a contracted, discounted rate.

Below is an example of the difference between in-network and out-of-network services on the medical POS plan. Please keep in mind that this is just an example and does not reflect actual pricing of costs or services:

Aetna Medical POS Example: You are having a baby, normal delivery. We will assume the estimated charges considered to be usual, customary and reasonable for the hospital stay and routine obstetric care amount to $6,000.

In-Network:
Applied deductible: $0 (there is no annual deductible on this plan)
Your percentage of cost in-network: 10% which equals $600
Total estimated cost in-network for these services: $600

Out-of-network:
Applied deductible: $0 (there is no annual deductible on this plan)
Separate hospital deductible: $500
Your percentage of cost out-of-network: 50% which equals $3,000
Total estimated cost out-of-network for these services: $3,500

By choosing an out-of-network physician or hospital for the normal delivery of your baby, you pay $2,900 more than if you sought these services from an in-network physician and hospital.

There is really no reason to seek services out-of-network unless you already have a relationship with a particular trusted medical professional from whom you’ve received services in the past. Aetna has hundreds of physician choices, including specialists, in the greater Los Angeles area.

Garnett-Powers & Associates, Inc. is pleased to offer a University of Southern California PBP Customer Service Representative, dedicated to this program. Please address benefit and enrollment questions to:

Garnett-Powers & Associates, Inc.
23361 Madero, Suite 240
Mission Viejo, CA 92691
Or call us Monday - Friday, 8 am - 5 pm Pacific Time
Toll free at 1-800-319-9557

Contact USC-PBP Program Services
USCPBP@Garnett-Powers.com

We thank you for the opportunity to be of service to you and your family.

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Program and benefit information contained on this site has been deemed reliable, but can change without notice.

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23361 Madero, Suite 240, Mission Viejo, CA 92691
(949) 583-2925 - FAX (949) 583-2929 - Toll Free (800) 319-9557
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