Insurance Glossary

Insurance Term - Point-of-Service (POS) Plan

Point-of-Service (POS) Plan is a health insurance policy that allows the employee to choose between in-network and out-of-network healthcare products and services each time, whenever medical treatment is required by the concerned individual. A POS plan is a ‘HMO/PPO’ hybrid; sometimes referred to as an ‘open-ended’ HMO when offered by an HMO. POS plans resemble HMOs for in-network services. Services received outside of the network are usually re-imbursed in a manner similar to conventional indemnity plans (e.g., provider re-imbursement based on a fee schedule or usual, customary and reasonable charges). In brief, POS is a plan that allows members to receive services from a participating or non-participating network provider, usually with a financial disincentive for going outside the network.

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