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What Is a Point of Service (POS) Plan?

A Point of Service plan, or POS, is a health plan that uses certain doctors and hospitals, called your POS provider network. A POS plan has a lower premium than a PPO plan, but still provides options for choosing health care providers. These added choices may give you more flexibility when you need care.

POS plan features:

  • You’ll choose a primary care physician (PCP) from the POS network to manage your health care needs.
  • You’ll have a lower deductible and coinsurance if you see a provider in the POS network.
  • You can see an out-of-network provider, but you will pay more of the bill.
  • Emergency services are covered at the highest benefit level whether the provider is in the POS network or not.
  • For the few covered services not available within the POS network, you may see an out-of-network provider at the in-network benefit level.
  • You don’t need a referral to see a specialist. But make sure your PCP knows of the providers in this network.

Is a POS Right for You?

When shopping for a health plan for you and your family, ask these questions to see if a POS may be right for you:

  • What type of health care do I expect for the coming year?
  • Are the doctors and hospitals I use now, and may need in the future, in the POS network?
  • If not, am I willing to see different providers so I have a lower monthly premium?
  • Which POS plans are available, compared with the broader PPO networks?

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Need Assistance Shopping?

Sales Questions and Additional Plan Information:
1-855-594-1515
Calls may or may not be answered inside the United States.

Monday – Friday: 7 a.m. – 7 p.m. MT
Saturday: 7 a.m. – 5 p.m. MT
Sunday: 9 a.m. – 1 p.m. MT

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Calls may or may not be answered inside the United States.

Monday – Friday: 6 a.m. – 7 p.m. MT
Saturday: 7 a.m. – 4 p.m. MT
Sunday: Closed

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New to Medicare or Need Help Shopping for a Plan?

Call us at 1-866-940-3022 TTY 711

We’re open between 8 a.m. – 8 p.m., local time, 7 days a week. If you’re calling from April 1 through September 30, alternate technologies (for example, voicemail) will be used on the weekends and holidays.