How Point of Service (POS) Health Plans Work

A POS (Point of Service) health insurance plan gives you access to large network of doctors, hospitals, clinics, specialists, and other health care professionals. POS plans usually have affordable rates, as long as you receive your care from the within the network plan.

POS plans are a kind of managed care plan, like PPOs and HMOs. And POS plans share some of the features of both.  

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Similarities With PPO Plans

Like a PPO plan, your POS plan will have two levels of coverage: in-network and out-of-network. You’ll pay less for medical care when you choose a doctor or hospital within your plan’s network. But if you decide to get care outside the plan network, you’ll still have coverage.

That gives you the flexibility to get care wherever you want — and still be covered. It’s especially useful if you already have a doctor who isn’t part of your new plan’s network. You can continue to see that doctor and still have some coverage.

Similarities With HMO Plans

A POS plan will offer more flexible coverage than an HMO, but they have one key similarity. Like an HMO, you’ll have to choose a Primary Care Physician (PCP).

Your PCP will be the first doctor you go to for medical care. If you need to see a specialist, you can get a referral from your PCP.

The referral is like a “stamp-of-approval” from your Primary Care Physician — and it just about guarantees that you’ll be covered for the care you receive from the specialist. You’ll also have the most coverage when you get a referral.  

What Kinds of Care Do POS Plans Cover?

POS plans provide comprehensive benefits including coverage for:

• Preventive and routine care
• Emergency and urgent care
• Hospital care and services
• Prescription drugs

Choosing the Right Plan

Is a POS plan right for you? Use our Instant Quote Tool to compare health insurance plans instantly. You’ll be able to view rates and benefits online — to find the right plan for your health and budget needs.

You can also get competitive quotes from multiple local agents, or speak with an agent on the phone right now.

And all our services are no-risk, no-obligation, and absolutely free.