Point-of-Service Plan (POS)
What is a point-of-service plan (POS)?
A point-of-service plan (POS) is a type of managed care plan that falls between a PPO and an HMO. Through a POS, participants pay less when using hospitals, doctors, and other healthcare providers within the plan’s network.
Participants of a POS choose an in-network physician as a primary care provider, similar to an HMO. However, patients can go out-of-network for certain healthcare services, like with a PPO.
With a referral from the primary care provider to the out-of-network provider, the medical plan will pay some or all of the costs of the visit. Without a referral, the patient will have to pay most of the cost.
Why is a POS plan important to healthcare?
POS plans improve healthcare because they make healthcare more affordable. When using healthcare providers within the plan's network, services cost less. Some plans have multiple tiers that vary based on how much of the visit is covered, allowing participants to choose a provider they can afford.
However, POS plans still offer flexibility in being able to visit a provider outside of the network, albeit at a higher out-of-pocket cost. This flexibility can appeal to those who want to see a specialist.