Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
A point-of-service (POS) plan is best described as a managed care model that:
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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 of an HMO and a PPO. Like an HMO, the member selects a primary care physician who acts as a gatekeeper and must give referrals for specialist care. Like a PPO, the plan permits out-of-network care, but at a higher out-of-pocket cost than in-network care. This design tries to combine HMO cost control with PPO flexibility, making the POS a distinct care-plan delivery model that agents must be able to distinguish from HMO, PPO, and EPO arrangements when counseling consumers.
Why the other options are wrong
- B) A POS plan does not eliminate network distinctions; out-of-network care is available only at higher cost-sharing, and a PCP and referral are generally required for in-network care.
- C) Refusing to pay for out-of-network care describes an exclusive provider organization (EPO), not a POS plan, which permits out-of-network use at higher cost.
- D) A staff model is one HMO delivery arrangement, not a description of POS plans, which allow some out-of-network care.
Memory hook
POS = HMO's gatekeeper with PPO's escape hatch — out-of-network care costs more but exists.