A Point-of-service (POS) plan can be thought of as a hybrid between a PPO and an HMO plan. Like with so many aspects of the Health Insurance industry today things are changing and evolving and while this is not a precise answer there is no precise model for a POS.

A POS plan is similar to a PPO in that the policyholder can select a provider from a specified Network, but like an HMO there is either no or limited payment when the provider is not in the network. It is also like an HMO in that you are required to see a “primary care” provider or “gatekeeper” before accessing specialists. All care must be pre-authorized.

Some POS plans will authorize payment for a non-POS specialist, but typically only in the event another specialist in the POS is not readily available.

In any event, POS policies premiums tend to be less expensive than either an HMO or PPO due to the restrictive nature of the plans and the limited amount the Insurance carriers typically reimburse POS providers. There may also be a quality of care issue, if the POS is too small.

Another variation on POS are Exclusive Provider Organizations (EPO) are similar to POS, except that they do not provide any benefit if the insured chooses a non-preferred provider, except for some exceptions in cases of emergencies.

You should contact a Licensed Certified Field Broker/Agent ( Click Here) to review the specific plans available in your area to determine whether a POS options is available and how well it may meet you needs given the Limitations and restrictions. The redeeming value of a POS plan lies only in the low Premium cost typically associated with such plans.

Also be sure to read about the three Cs of health care plans Cost, Coverage and Control (Click Here ).