POS Plan

POS stands for Point-Of-Service. A POS plan borrows a little bit from both an HMO and a PPO. Like both an HMO and a PPS, a POS plan has a network of doctors, specialists, hospitals and other health providers who have agreed to provide services at a set fee which is lower than their normal fee. That means the POS plan saves money when you use POS-approved doctors and hospitals.

As with an HMO, you choose a Primary Care Physician when you join a POS. Your Primary Care Physician must be a member of the plan. This means that if your long-time family physician is not a member of your POS then you will have to choose a new doctor or you will have to pay the majority of the cost to see your long-time family doctor out of your own pocket.

Your Primary Care Physician is responsible for overseeing all of your health care needs and treatments. As long as you see your Primary Care Physician you will only be responsible for a small co-payment for each visit, typically somewhere between $5 and $25, depending on the monthly premium you have chosen.

With a POS you have greater latitude in choosing your doctor than you do with an HMO. You can, if you wish, see a doctor that is not a member of the POS. However, doing do means that you will need to pay the doctor’s bill out of your own funds and then submit the bill to your POS for a partial payment.

The main difference between a POS and a PPO is that your Primary Care Physician may refer you to an out-of-plan doctor for special treatment and so long as your Primary Care Physician referred you to the out-of-plan doctor your POS Plan will pay the non-plan doctor the same as if the doctor were an in-plan doctor.

A POS plan is somewhat of a hybrid between an HMO and a PPO and may be the right choice for someone who has an on-going need for specialist treatment.