Managed Care Insurance

What is a point-of-service plan?

A Answers (2)

  • A Point of Service (POS) plan is a type of managed care plan that allows members to choose to receive care from a participating or non-participating health care provider, with different benefit levels associated with the use of participating physicians. Similar to the PPO and HMO, the POS managed care plan has a group of health care providers and hospitals that are contracted to be part of the network. Members of a POS are encouraged but not required to select a primary care physician (PCP) for referrals. If members use a PCP for referrals, they may pay lower deductibles and copayments than a member who does not use a PCP. This managed care plan gives members more flexibility and freedom to play a role in their personal health care than a traditional HMO.
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  • A , Cardiology (Cardiovascular Disease), answered
    With a point-of-service health insurance plan, you have the choice of using any physician and getting any service without needing a referral from your primary care doctor (like in an indemnity plan). However, the insurance carrier has a network of doctors, hospitals and other care providers that it has negotiated discounts with, and you have a financial incentive to use those "in-network" providers. You'll pay more (usually, a lot more) for using out-of-network doctors and hospitals.

    The premiums usually run a little less than traditional indemnity plans, and there may be less paperwork because your doctor's office will likely have frequent (if not daily) contact with the insurance company.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
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