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Point-Of-Service (POS) Plan

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What Is A Point-Of-Service (POS) Plan?

A point-of-service (POS) plan is a managed care health insurance plan where policyholders enjoy certain benefits, such as paying fewer fees, seeking medical attention from doctors, hospitals, and other health care providers who belong to the plan network.

Deeper Definition

The point-of-service plan is a health insurance plan that combines the best features of a health maintenance organization (HMO) and the preferred provider organization (PPO). It provides policyholders different benefits depending on whether they get medical attention from in-network or out-of-network healthcare providers.

A POS plan is similar to an HMO because when a person enrolls for the plan, they are to choose a primary care physician who will make referrals for them when they need a specialist’s service. The primary care physician may refer a policyholder to healthcare providers outside the network. Though this would attract less compensation from their insurance.

A POS plan is similar to a PPO because it provides policyholders coverage even when using out-of-network services, though they have to pay more in contrast to using in-network services. Using out-of-network services sees policyholders pay deductibles which tend to be high. Also, when using out-of-network, policyholders will fill all the paperwork themselves, unlike in-network, where someone does it for them. 

POS plans are often cheaper when compared to other insurance policies. However, the savings are usually when a patient visits in-network providers. Typically, the plan provides nationwide coverage, which can be beneficial to patients who frequently travel. It allows them to still take advantage of the benefits associated with using in-network health care providers.

Point-Of-Service (POS) Plan Example

Mary enrolled for a health insurance plan that allows her to enjoy certain benefits whenever she seeks medical attention from doctors and other health care providers who belong to the plan’s network. Mary has the liberty to seek medical attention from health care providers who do not belong to the network. However, she would lose out on some of the benefits. The health insurance plan Mary is on is known as the Point-Of-Service (POS) Plan.

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