A point-of-service (POS) health plan combines features of which two managed care delivery models?
Select an option to reveal the answer and the full 3-part explanation — free, no signup.
Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
A POS plan merges the two dominant managed care models: it uses an HMO-like primary care physician (PCP) who coordinates care and issues referrals within the network, while also permitting members to seek care from out-of-network providers, usually at a higher deductible and coinsurance level. The gatekeeper element keeps utilization and cost down, while the out-of-network option adds member flexibility. Under the examination outline for individual medical plans (AH-III.A.1a), POS plans are classified alongside HMO, PPO, and EPO as a distinct delivery type, so recognizing this hybrid structure is a tested point.
Why the other options are wrong
- B) An EPO does not allow out-of-network coverage except emergencies, so a POS, which does permit out-of-network care, cannot be an HMO/EPO hybrid.
- C) Indemnity plans have no network or gatekeeper management; a POS retains managed care coordination, so pairing it with pure fee-for-service reimbursement is wrong.
- D) Network structure and HSA tax treatment are unrelated issues; POS plan design has no bearing on HSA eligibility.
Memory hook
POS = Point Of Service: follow the gatekeeper inside, roam freely outside the network.