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Direct answer

A POS plan is a hybrid model; it functions like an HMO by requiring a primary care gatekeeper, but mimics a PPO by allowing you to visit out-of-network providers at a higher out-of-pocket cost. Whether it is better depends on your specific budget and whether you prioritize network flexibility over lower monthly premiums.

Standardized healthcare plan classification and health insurance industry compliance standards. For additional information about health plan categories, see the HealthCare.gov guide to plan types.


What this means for you

A POS plan is a hybrid model; it functions like an HMO by requiring a primary care gatekeeper, but mimics a PPO by allowing you to visit out-of-network providers at a higher out-of-pocket cost. Whether it is better depends on your specific budget and whether you prioritize network flexibility over lower monthly premiums.

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