Which statement best describes a point-of-service (POS) plan?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
A POS plan is a hybrid managed care product. In-network, it works like an HMO: the member selects a primary care physician, and in-network care requires a referral or is coordinated through the plan. However, unlike a pure HMO, a POS plan permits members to go outside the network for care, usually paying higher deductibles, coinsurance, or copayments and often without the same level of plan coordination. The decision is made at the point of service, which is where the plan gets its name. This flexibility is the key feature that distinguishes a POS plan from a standard HMO.
Why the other options are wrong
- B) A POS plan does have a network and a primary care structure; a plan with no network that pays any charge is a traditional indemnity or fee-for-service plan.
- C) POS plans cover the full range of medical services, not only emergency hospital care.
- D) Premium payment is a policy funding condition, not a defining feature of any plan type, and POS plans do not operate that way.
Memory hook
POS = HMO gatekeeping inside, out-of-network option outside, chosen at the point of service.