What is POS or Point of Service?
Some HMO’s offer plan members the option to self direct care, as under a PPO plan, rather than get referrals from primary care physicians. An HMO with this opt-out provision is known as a point-of-service (POS) plan. How the plan functions (i.e. like an HMO or like a PPO plan) depends on what the individual plan members decide to do at the point-of service, as well as on the particular plan design. Typically, when medical care is needed, the individual plan member has three choices. The plan member can choose to go through his or her primary care physician, in which case services will be covered per the policy’s regular HMO guidelines. Alternatively, the plan member can access care through a PPO provider and the services will be covered under in-network PPO rules. Some carriers permit this only outside their service area while others allow this in- or outside their service area. Finally, if the plan member chooses to obtain services from a provider outside of the HMO and PPO networks,
