A Point of Service (POS) plan combines the best features of the HMO and the PPO.

Like HMO members, POS members choose a primary care physician. Preventive care services are covered when provided or arranged by the primary care physician.

POS members are free to see any doctor. The level of coverage for services is determined by whether care is provided or arranged by the primary care physician (higher level), or whether the member self-refers (lower level) to a participating or nonparticipating provider.

POS Characteristics

• Primary care physician can act as a gatekeeper.
• Coverage is selected at the point of service. The patients can use either network or non-network care at any time.
• If the patient follows HMO guidelines, benefits are paid by HMO rules.
• The patient has the option of seeing a provider outside of the network, but the patient’s out-of-pocket cost will increase.

To learn more about Preferred Provider Organizations, click here.