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A point of service plan is a type of managed care health insurance plan in the United States. It combines characteristics of the health maintenance organization (HMO) and the preferred provider organization (PPO). [1] The POS is based on a managed care foundation—lower medical costs in exchange for more limited choice. But POS health ...
A Point of Service plan falls between HMOs and PPOs in terms of cost and combines features of both plans. POS plans allow you to choose what type of care you want at the beginning of every visit ...
An HMO Point-of-Service (HMO-POS) plan is a type of HMO plan. With an HMO-POS plan, an individual must choose a PCP, but they can use out-of-network services at a higher cost, similar to a PPO plan.
A POS plan uses some of the features of each of the above plans. Members of a POS plan do not make a choice about which system to use until the service is being used. In terms of using such a plan, a POS plan has levels of progressively higher patient financial participation, as the patient moves away from the more managed features of the plan.
HMO Point of Service plans HMO-POS plans allow individuals to get some services from out-of-network providers. These plans require a higher coinsurance or copayment.
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An HMO Point-of-Service plan is more flexible than an HMO plan. A person will still need to select a PCP, but members can access healthcare outside of the HMO network at a higher cost.