A point of service plan is a type of

managed care The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("man ...

health insurance Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...

plan in the United States. It combines characteristics of the

health maintenance organization In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded healt ...

(HMO) and the

preferred provider organization In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care ...

(PPO). The POS is based on a managed care foundation—lower medical costs in exchange for more limited choice. But POS health insurance does differ from other managed care plans. Enrollees in a POS plan are required to choose a

primary care physician A primary care physician (PCP) is a physician who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis. The term ...

(PCP) from within the health care network; this PCP becomes their "point of service". The PCP may make referrals outside the network, but with lesser compensation offered by the patient's health insurance company. For medical visits within the health care network, paperwork is usually completed for the patient. If the patient chooses to go outside the network, it is the patient's responsibility to fill out forms, send bills in for payment, and keep an accurate account of health care receipts.

References

Glossary
Federal Employees Health Benefits Program,

U.S. Office of Personnel Management The United States Office of Personnel Management (OPM) is an independent agency of the United States Federal Government that manages the US civilian service. The agency provides federal human resources policy, oversight and support, and tends t ...

(URL updated September 7, 2009).
Definitions of Health Insurance Terms
U.S. Interdepartmental Committee on Employment-based Health Insurance Surveys (URL retrieved September 30, 2006). *Sankey, Judith A., "''Employee Benefit Plans: A Glossary of Terms''", International Foundation of Employee Benefit Plans, 1997, . Health insurance in the United States Managed care {{insurance-stub