Difference Between HMO and POS

HMO vs POS

POS, or Point of Service, and HMO, or Health Maintenance Organization, are the various types of Managed Healthcare Plans in the US. These health care insurances help the employees with their medical bills.

When considering a HMO plan, it is more restrictive than the POS. A person who has taken a HMO plan, has to opt for a Primary Care Physician (PCP) from the network of contracted doctors in his area. It is the Primary Care Physician who coordinates the employees’ medical care. In the case where an employee has to seek the help of a specialist, the PCP will make a referral, with whom the costs are minimised.

The Point of Service can be said to be a hybrid of HMO and PPO (Preferred Provider Organization) plans. The POS is a more flexible plan than the HMO. Employees choosing a POS plan can seek any doctor within, or outside, the network of contracted doctors.

One of the main differences between the two medical insurance plans, is that an employee opting for POS plan can have the benefits of both POS and HMO plans. On the other hand, the HMO plan has very strict guidelines.

Another difference is that there is no need to choose a PCP in a POS plan, whereas, it is needed in a HMO plan. If an employee does not have a PCP when he has a HMO plan, then he or she will shoulder the entire bill. On the other hand, if there is no POCP under a POS plan, then he or she will just have to pay a coinsurance.

In case of HMO plans, one needs to get a referral by the PCP in order to consult a specialist. On the other hand, if an employee has taken a POS plan, he can directly approach a specialist of his desire.

Summary:

1. An employee opting for the POS plan can have the benefits of both POS and HMO plans. On the other hand, the HMO plan has very strict guidelines.

2. The POS is a more flexible plan than the HMO.

3. Another difference is that there is no need to choose a Primary Care Physician in a POS plan, whereas, it is needed in a HMO plan.

4. One needs to get a referral by the PCP in order to consult a specialist. On the other hand, if an employee has taken a POS plan, he can directly approach a specialist of his desire.

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