Georgia Navigator Practice Exam

What best describes a Point of Service (POS) plan?

1. A combination of a PPO and HMO plan using a contracted network of providers

2. Insurance coverage that only allows services from in-network providers

3. A low-deductible insurance plan that covers all medical expenses

4. A service that provides no referrals for specialist services

The correct answer is: A combination of a PPO and HMO plan using a contracted network of providers

A Point of Service (POS) plan is best described as a combination of a Preferred Provider Organization (PPO) and a Health Maintenance Organization (HMO) using a contracted network of providers. In a POS plan, members have the flexibility to choose between receiving care within the network, which typically requires lower out-of-pocket costs, and seeking services outside the network, which may involve higher expenses. This dual approach combines the managed care aspect of an HMO, where care is coordinated and usually requires referrals for specialists, with the more flexible access characteristic of a PPO, allowing members to go out-of-network if they prefer. This flexibility is a defining feature of POS plans, making them appealing to individuals who want both lower costs for in-network services and the option to access care outside of the network when necessary. Other options inaccurately describe the structural and operational elements of a POS plan. For instance, an option may suggest that coverage only allows services from in-network providers, which does not capture the out-of-network flexibility a POS plan offers. Another option might propose that it is a low-deductible insurance plan covering all medical expenses, lacking the specifics of its mixed model and the associated costs of out-of-network services. Additionally, the idea of a service