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Point of service plans (POS)

A POS, or point of service plan, is a type of managed care plan that is a hybrid of HMO and PPO plans. Like an HMO, participants designate an in-network physician to be their primary care provider. But like a PPO, patients may go outside of the provider network for health care services. When patients venture out of the network, they’ll have to pay most of the cost, unless the primary care provider has made a referral to the out-of-network provider, in which case, the medical plan will pick up the tab.

What is covered?

Usually comprehensive

Whom can you see?

Any doctor referred by primary care physician; benefits reduced for services outside the network if not referred by PCP.

Cost-sharing at time of service

Contact a broker for detailed information on costs.

Monthly premium**

Contact a broker for premium quotes, but the national average is roughly $600/month. 


Offers more flexibility than HMOs but less than PPOs. Employees should be willing to assume responsibility for some administrative duties (such as obtaining referrals or submitting claims).