What is a POS plan?

What Is A POS Plan? 

A POS plan, also known as a point of service plan, as a type of healthcare plan. It is a managed healthcare plan that has some of the characteristics of an HMO, or health maintenance organization plan, as well as other characteristics of a preferred provider organization plan, or PPO.

A POS is a managed foundation and is a plan that provides lower amounts of medical cost in exchange for having fewer choices available. Health insurance of this type has differences from the other managed healthcare plans.

Notably, people who enroll in a POS plan must choose a primary care physician, or PCP, that is in their network. This means that the POS has negotiated rates with the person you have selected as your primary care physician. A primary care physician can make referrals that are outside of the provider's network, but there is less compensation offered to these out of network providers from the policyholder's health insurance company.

Each time a medical visit occurs within the healthcare network, the patient is responsible for completing the necessary paperwork. It is also the patient's responsibility to fill out forms, send the bills in for payment, and keep an accurate account of health care receipts if the policyholder decides to go out-of-network for care.

How Does A POS Plan Work?

A POS plan works in similar ways to other plans, though the provider options are little more limited than other plans. With the primary care physician being a requirement of most POS plans, referrals are needed to get care from other doctors or specialists. Unless the primary care physician provides a referral to the out-of-network provider, the patient's/policyholders responsible for the costs.

A POS Plan May Be Right For You If

For people that are willing to take the extra time to follow the rules and coordinate the care they receive through their primary care physician, a POS plan may be an excellent choice. It can also be a fantastic choice for people who already have a primary care physician that they prefer for all of their care to go through. If a person's favorite doctor it is already participating in the POS network, it does not hurt to talk with that doctor about whether or not a POS plan they participate in could be the best one for you.