Point-of-Service Plan
What Does Point-of-Service Plan Mean?
A point-of-service (POS) plan is a type of healthcare plan that allows individuals to select a primary care physician from within a network. While the choice of providers is limited, a POS plan offers medical care at a lower cost. If the primary care physician is unable to provide the necessary care, they can refer the patient to an out-of-network specialist. However, compensation for out-of-network physicians is typically lower compared to other types of health insurance, such as health maintenance organizations (HMOs) and preferred provider organizations (PPOs).
Insuranceopedia Explains Point-of-Service Plan
A point-of-service (POS) plan is a managed health insurance plan that combines features from the more common health plans, specifically health maintenance organizations (HMOs) and preferred provider organizations (PPOs). It is similar to a PPO in that it allows patients to designate a primary care physician within the network, who serves as the “point of service.” Conversely, it resembles an HMO in that it enables patients to request referrals from their POS physician to seek care from out-of-network specialists. When visiting out-of-network providers, patients are responsible for completing the necessary forms, paying any excess out-of-pocket costs, and keeping track of medical care receipts.
While the range of services may be somewhat limited, POS plans typically offer medical care at rates lower than those of other plan types. Often, visits to primary care physicians under POS plans are not subject to a deductible, which can be viewed as a significant advantage. Many people obtain POS health insurance plans through their employers, as enrolling in an employer-sponsored health insurance program is usually easier and more cost-effective than purchasing an individual plan.
