Point-of-Service Plan (POS)

Also called: POS

A point-of-service plan mixes features of HMO and PPO coverage: you usually choose a primary care doctor and need referrals like an HMO, but you can still get partial coverage for out-of-network care like a PPO. Your costs depend heavily on whether you follow the referral rules and stay in network. Missing a required referral is a common, and often appealable, reason a POS claim is denied.

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Disclaimer: This definition is provided for general educational purposes only and is not legal, medical, or insurance advice. Insurance rules, deadlines, and terminology vary by plan, state, and over time. Always check your own plan documents and confirm current details before acting.