Fundamentos de Accidente y SaludPregunta 483 de 716
A Point-of-Service (POS) health plan is best described as:
a.A hybrid that blends HMO features with the option to go out of network at a higher cost
b.A pure fee-for-service indemnity plan with no network
c.A plan that provides no coverage outside a fixed network under any circumstances whatsoever
d.A plan identical in every way to a standard HMO
Explicación
A POS plan combines HMO and PPO characteristics: members typically choose a primary care physician and use the network for the lowest cost, but they may also go outside the network at the point of service by paying more. It is not a pure indemnity plan, not identical to an HMO (it allows out-of-network use), and it does provide some out-of-network coverage. The 'point of service' name reflects that the member decides in or out of network each time care is needed.
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Revisado por John Zihao Zhang — California-Licensed Life Insurance Agent (CA Dept. of Insurance License #4396095 — verificar)