What distinguishes a POS (Point of Service) plan?

A POS (Point of Service) plan is distinct because it combines the features of both health maintenance organizations (HMOs) and preferred provider organizations (PPOs). This means that it allows members to choose between receiving care from network providers at reduced costs or seeking services from out-of-network providers, albeit at higher costs.

This flexibility makes a POS plan attractive to individuals who may want the lower premiums and managed care of an HMO but also the option to obtain care outside of the network if they so choose. The ability to go out of network, while also having certain advantages when utilizing in-network services, is what sets POS plans apart from other types of health insurance plans.

While referrals for services may be a common feature of many POS plans, the defining characteristic is the ability to access both in-network and out-of-network benefits. This combination is what offers members wider choices in their healthcare options, addressing different medical needs and preferences.