POS Insurance: Point of Service Plan

Avg. premium: $510/mo | Deductible: $1,600

What Is POS Insurance?

A POS plan combines features of HMO and PPO. You choose a PCP who provides referrals (like HMO) but can also go out-of-network at a higher cost (like PPO).

Monthly Premium
$510
Deductible
$1,600
Copay
$20-$40 per visit
Flexibility
Medium

Who Is POS Best For?

People who want the cost savings of an HMO with the safety net of out-of-network coverage.

Pros and Cons

Advantages

  • Out-of-network coverage available
  • Lower in-network costs than PPO
  • PCP coordinates care
  • Flexibility for out-of-area care
  • Good for families with varied needs

Disadvantages

  • Requires PCP referrals for specialists
  • High out-of-network costs
  • More paperwork than HMO
  • Can be confusing to navigate
  • Less common in marketplace plans

Key Features

Referrals RequiredYes
Out-of-Network CoverageYes (at higher cost)
Network FlexibilityMedium
Family Premium$1,450/mo

Frequently Asked Questions

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