Which term best describes a plan that combines features of HMOs and PPOs and is commonly referred to as a POS plan?

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

Answer: (D)

POS plans, short for Point of Service, are a hybrid that blends features of HMOs and PPOs. They’re best described as a type of managed care plan because their structure aims to control costs while coordinating care. With a POS plan you typically choose a primary care physician and may need referrals to see specialists when you stay in-network, which mirrors HMO gatekeeping. But you also have the option to go outside the network for care, similar to a PPO, albeit with higher out-of-pocket costs. This combination is why the general category that fits best is a managed care plan. The other plan types are more rigid or more flexible on network use: HMOs emphasize in-network care with strict gatekeeping; PPOs emphasize provider flexibility with broader out-of-network coverage; EPOs usually restrict coverage to in-network providers. POS sits between them, hence described as a managed care plan.