Health Insurance
POS Plan (Point of Service)
A POS plan gives you the structured primary-care model of an HMO with the escape valve of limited out-of-network benefits.
Last reviewed: May 2026 · Editorial methodology
Definition
A Point of Service (POS) plan is a managed care arrangement that combines characteristics of both HMO and PPO plans. Like an HMO, members select a primary care physician (PCP) who coordinates all care and issues referrals to in-network specialists. Like a PPO, members retain the option to seek care outside the network, although doing so triggers significantly higher cost-sharing — sometimes 40–50% coinsurance plus a separate out-of-network deductible. Premiums for POS plans typically fall between the lower cost of HMOs and the higher cost of PPOs. POS plans work well for individuals who want a care coordinator but occasionally need a specialist not available in the network. Always confirm whether the plan charges a referral fee and what the out-of-network deductible resets independently of the in-network deductible.
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Cover Forge USA Editorial Team
Editorial Lead
This article was researched and written by the Cover Forge USA editorial team against federal sources (NAIC, CMS, FEMA, DOL, SSA, state DOIs) and standard policy forms. Bylines organize content by topic — they do not assert individual licensure. See our editorial-policy for details.
Reviewed 2026-06-14
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