Which statement correctly describes a point-of-service (POS) plan?

Why A is correct

A POS plan is the hybrid of HMO and PPO designs. Like an HMO, the member selects a primary care physician (PCP) who coordinates care and can make referrals; in-network care follows HMO-style managed benefits. Like a PPO, the plan still allows care outside the network, but at a higher cost share — typically a deductible and higher coinsurance — especially when the member goes out of network without a referral. The exam tests the POS as the middle-ground plan type between the network-only HMO and the network-flexible PPO.

Why the other options are wrong

• B) No plan type covers out-of-network care at the same cost as in-network care; out-of-network access always carries higher cost-sharing in a POS. The whole point of network tiers is that out-of-network use costs more.
• C) A POS plan does require selection of a primary care physician; the out-of-network privilege does not eliminate the PCP requirement or provide full benefits. The PCP requirement remains in a POS, even with the out-of-network option.
• D) Restricting members to network care with no out-of-network benefits describes an HMO or EPO, not a POS plan, which expressly permits out-of-network access. The POS expressly keeps an out-of-network option, unlike an HMO.

Memory hook

POS = PCP gatekeeper like an HMO, plus a paid ticket out of network like a PPO. Hybrid benefits, hybrid costs.