Point of service plan
Encyclopedia
A point of service plan, or POS plan, is a type of managed care
Managed care
...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on...

 health insurance
Health insurance
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...

 system. It combines characteristics of both the HMO and the PPO
Preferred provider organization
In health insurance in the United States, a preferred provider organization is a managed care organization of medical doctors, hospitals, and other health care providers who have covenanted with an insurer or a third-party administrator to provide health care at reduced...

. Members of a POS plan do not make a choice about which system to use until the point at which the service is being used.

The POS is based on the basic managed care foundation: lower medical costs in exchange for more limited choice. But POS health insurance does differ from other managed care plans.

When the patient enrolls in a POS plan, they are required to choose a primary care physician to monitor the patient's health care. This primary care physician must be chosen from within the health care network, and becomes their "point of service".

The primary POS physician may then make referrals outside the network, but then only some compensation will be offered by the patient's health insurance company.

For medical visits within the health care network, paperwork is completed for the patient . If the patient chooses to go outside the network, it is the patient's responsibility to fill out the forms, send bills in for payment, and keep an accurate account of health care receipts.
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