A Point of Service (POS) plan combines aspects of health maintenance organization (HMO) and preferred provider organization plans (PPO). Like an HMO plan, you will need to choose a primary care physician (PCP) to manage referrals to specialists.
Like a PPO, Point of Service (POS) plans cover some service fees for out-of-network providers. If you PCP refers you to an out-of-network specialist, your POS will cover more of the fees than without the referral.
However, you will still pay more to go to a provider who is out of network than one who is in your plan’s network. You will also be responsible for paperwork when you visit an out-of-network medical provider.
POS premiums are somewhere between the HMOs and PPOs. They are often half as much as PPOs but twice as much as HMOs. POS plans also small copayments for services.
The biggest benefit with POS plans is that there are typically no deductible for services from in-network providers. POS premiums are higher than HMOs, but you could save a lot by staying in-network if you require more frequent care.
There is a deductible for services from out-of-network providers, and they are usually high. A POS plan might be a better option than HMOs if you travel a lot, since they offer nationwide coverage and cover a portion of out-of-network fees.
However, if you get almost all of your care at home and want a low-cost plan, you may be better off with an Exclusive Provider Organization (EPO) plan.
Read on to learn about EPOs, how they work and what the benefits are.