Point of service plan
A point of service plan, or POS plan, is a type of managed care health insurance system. It combines characteristics of both the Health maintenance organization (HMO) and the Preferred provider organization (PPO). Members of a POS plan do not make a choice about which system to use until the point at which the service is being used.
The POS is based on the basic managed care foundation: lower medical costs in exchange for more limited choice. But POS health insurance does differ from other managed care plans.
When the patient enrolls in a POS plan, they are required to choose a primary care physician to monitor the patient's health care. This primary care physician must be chosen from within the health care network, and becomes their "point of service".
The primary POS physician may then make referrals outside the network, but then only some compensation will be offered by the patient's health insurance company.
For medical visits within the health care network, paperwork is completed for the patient . If the patient chooses to go outside the network, it is the patient's responsibility to fill out the forms, send bills in for payment, and keep an accurate account of health care receipts.
- Glossary, Federal Employees Health Benefits Program, U.S. Office of Personnel Management (URL updated September 7, 2009).
- Definitions of Health Insurance Terms, U.S. Interdepartmental Committee on Employment-based Health Insurance Surveys (URL retrieved September 30, 2006).
- Sankey, Judith A., "Employee Benefit Plans: A Glossary of Terms", International Foundation of Employee Benefit Plans, 1997, ISBN 0-89154-513-1.
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