Definition:
A Point-of-Service (POS) plan is a managed care plan similar to an HMO. With POS, the patient has a single primary care provider, but that provider can make referrals to providers both in and out-of-network. The plan covers in-network providers at a favorable rate, but the patient will be responsible for higher out-of-pocket costs if they use an out-of-network physician.
This type of plan is more flexible than an HMO because the enrollee does have the option to go outside of the network to seek care. However, because the payment rate for out-of-network providers is higher, patients have an incentive to stay in-network.
