Which of the following is considered to be a point of service (POS) plan?

• A. Managed Care Plan
• B. Health Maintenance Organization
• C. Preferred Provider Organization
• D. Exclusive Provider Organization

Answer: (A)

A point-of-service plan is a type of managed care arrangement that blends features of an HMO and a PPO. In a POS plan, you typically choose a primary care physician and may need referrals to see specialists within the network, similar to an HMO. But unlike a pure HMO, you have the option to obtain care from providers outside the network, though at higher out-of-pocket costs and with different coverage levels. The key is that you decide, at the time of service, whether to stay in-network or go out-of-network, which is the “point of service” decision. By combining these elements, a POS plan sits between an HMO and a PPO, offering some network flexibility while maintaining a gatekeeper structure. The other plan types are more restrictive or more flexible in different ways: an HMO is network-restricted with typical referrals, a PPO offers broad provider choice with generally no gatekeeper, and an EPO covers only in-network care.