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 provider (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?

Last Updated: March 04, 2024