Point of Service

A Point of Service, or POS, medical plan is similar to a health maintenance organization plan except it gives the insured greater flexibility to seek care 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, which is responsible for providing medical care, preventative programs, 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 seeking help outside of the POS network.  This added flexibility comes at a cost to the insured.  When going out-of-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 a health maintenance organization, but sill less than most preferred provider organizations.