A Point-of-Service (POS) plan combines features of an HMO and a PPO. Its distinguishing characteristic is that members:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
A Point-of-Service (POS) plan is a hybrid managed care product. Members choose a primary care physician from the plan's network, and in-network care follows HMO-style rules with the PCP acting as gatekeeper and coordinating referrals. However, a POS plan also allows members to go outside the network for care, paying more, typically a higher deductible, coinsurance, or copayment, and often requiring a referral. This point-of-service choice, deciding at the time of care whether to stay in network or go out, is the distinguishing feature that sets POS plans apart from strict HMOs and EPOs.
Why the other options are wrong
- B) POS plans use a primary care physician as gatekeeper for in-network care; they do not send members directly to specialists without one.
- C) Out-of-network care in a POS plan is available but at a higher cost, so the cost difference is real and material.
- D) No medical plan provides all services free for a fixed annual fee; POS members still owe deductibles, copayments, and coinsurance.
Memory hook
POS = pick at the point of service: stay in network with the PCP, or pay more to roam outside.