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POS Health Insurance

What is a POS plan?

A Point of Service (POS) plan is a type of healthcare plan that charges less if you visit medical providers (i.e., physicians and hospitals) that participate in the plan’s network. However, like PPO plans, you do have the option to seek care from out-of-network providers.

How does POS work?

When you need medical attention and have a POS plan, you may choose to visit a doctor, hospital, or other healthcare facility that participates in your plan’s network in order to incur the least out-of-pocket expenses possible. However, if you choose to visit a provider that is out of your network, then you still benefit from coverage but out-of-network services have higher out-of-pocket costs.

Are POS plans expensive?

POS plans are designed to keep your costs low, as long as you visit providers who are in-network. POS plans will cost you more if you choose providers outside of your network, so you can limit your out-of-pocket costs by being mindful of where you receive care.

Am I eligible for a POS plan?

The Enrollment Period for 2021 coverage is re-opened! This is your yearly opportunity to enroll in a new healthcare plan. Act fast, this period closes on March 15th. Click here to explore your options.

Why should I choose a POS plan?

POS plans are known for being consumer-driven.

You can choose the provider that you want to see, whether they’re in-network or not.

You aren’t required to select a primary care physician, which is often a requirement for other types of healthcare plans.

You don’t need a referral to see an out-of-network specialist, which greatly increases your selection of integrated care providers.

Why should I NOT choose a POS plan?

Before choosing a POS plan, there are several important things to consider:

If your preferred provider is not in your would-be network, then continuously visiting an out-of-network provider will result in higher expenses for you.

There may not be many POS-participating physicians in your area. You shouldn’t settle for an in-network provider just because they are your only option if you want to keep costs low.

You may need to get a referral from a Primary Care Physician before you can receive care from an in-network specialist.

What are the alternatives to a POS plan?

There are several other healthcare plans available to meet your needs. Check out the links below for more information.


Health Maintenance Organization (HMO)

Great choice for people who want to keep their premiums low, especially if you’re happy to see your PCP first when you need more specialized care.

Learn more »


Exclusive Provider Organization (EPO)

Great for people who are conscious of their budget as they often offer lower premiums and cost sharing than PPOs. However, there’s no coverage for out of network care.

Learn more »


Preferred Provider Organization (PPO)

Perfect for people who prioritize choice and flexibility. Premiums are higher than other plan types but you’ll have coverage for more care providers.

Learn more »


Fixed-Indemnity Health Plans (FI)

A fixed-indemnity health insurance plan gives you a fixed cash benefit payout in case you experience a covered illness or injury.

Learn more »

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