Point of Service Health Plans

Point of service plans or POS insurance policies are similar to HMOs but offer more flexibility.

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POS health insurance: the basics

POS health insurance provides lower cost insurance with limits on choice.

Your health care is administered from a physician within the insurance network

Referrals outside the network may be made, but you are responsible for filling out the necessary paperwork in order to get reimbursement for medical costs.

POS health insurance: pros and cons

  • Free to use non network providers.
  • For network care, co-payments are low & no deductible.
  • Limited yearly annual out-of-pocket costs.
  • Co-payments for non-network care are high.
  • Deductible for non-network care.
  • Referrals for specialized care may be difficult to obtain.

POS health insurance: the price

Typically more expensive than an HMO but cheaper than a PPO, POS health insurance will consist of a monthly premium, a copayment for network care, and a deductible for non-network care.

POS health insurance: questions

As you are comparing policies ask the following questions about your POS health insurance.


  • How many doctors are in the network?
  • Is network made up of private or group practice physicians?
  • Are the network offices and hospitals conveniently located?
  • What is the procedure for specialist referrals?
  • What hospitals are covered?
  • How is emergency care handled?
  • What medical services are covered?
  • Are there any limits on medical services?
  • How much are the annual premiums?
  • What are the copayments for specific services?
  • How much will I pay for non-network physicians?
  • How much is the deductible and coinsurance for non-network care?
  • Is there a out of pocket maximum?


Here is a printer-friendly version of these questions.


Next: "Medical Savings Accounts".

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