What is a Point-of-Service (POS) Plan?

What is a Point-of-Service (POS) Plan?

What type of managed care health insurance plan combines features of both HMO and PPO plans?

Answer:

The correct answer is a) Point-of-Service (POS) Plan.

A Point-of-Service plan (POS) is a hybrid of a Health Maintenance Organization (HMO) and a Preferred Provider Organization (PPO) plan. It offers more flexibility in choosing healthcare providers compared to HMOs but at a higher cost. Under a POS plan, members can receive care from both in-network and out-of-network providers.

However, if members choose to receive care outside the network, they will typically have to pay higher deductibles, co-payments, and coinsurance fees. Within the network, the POS plan usually requires members to select a primary care physician (PCP) who coordinates their medical care and referrals to specialists.

POS plans provide a balance between cost and flexibility, making them a popular choice for individuals who want some freedom in choosing healthcare providers while still having some coverage for out-of-network care.