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A Point of Service or POS medical plan is similar to a health maintenance organization plan except it gives the insured greater flexibility in going out of network. When seeking in-network medical assistance, the point of service plan offers both general medical assistance and preventative or wellness care.
In a point of service plan, the employee chooses a primary care physician that is responsible for providing medical, preventative and specialist referrals. This care is provided with a small co-payment at the time of service.
The insured employee also has the option of going outside of the POS network. This added flexibility comes at a cost to the insured. When going outside network, the insured is usually responsible for paying both a deductible and a larger percentage of the medical services rendered or coinsurance payment. For example, if the medical services outside of network were $3,000 and the deductible was $1,000 and the coinsurance level was 30%, this means the patient would be responsible for $1,000 + $2,000 x 30% or $1,600.
The added flexibility of the point of service plan means premiums would be higher than health maintenance organization, but sill less than most preferred provider organizations.
Other forms of this term include -POS |
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