Point of Service Plan (POS Plan) Law and Legal Definition

A point of service plan (POS plan) is a type of managed care health insurance system that has the characteristics of both the HMO and the PPO. In a POS plan, a beneficiary upon enrollment will select a primary care physician from a list of participating providers, like in an HMO to monitor his/her health care. Since the elected physician directs all the medical care, s/he is called the ‘point of service.’ The POS plan differs from other managed care plans as the benefit levels vary depending on whether care is received from or out of the health insurance company's network of providers.

In a POS plan, the selected primary care physician will make referrals to network specialists when needed. The health insurance company will pay only some compensation for the care received from non-network providers. With a POS plan, a beneficiary is responsible for co-payments, coinsurance, and an annual deductible. It offers lower medical costs in exchange for more limited choice.