POS plans — HMO structure with some out-of-network flexibility.
A POS plan combines features of HMOs and PPOs: you choose a primary care provider (PCP) who coordinates your care (like an HMO), but you can also see out-of-network providers at higher cost (like a PPO). Less common on the marketplace, but available through some carriers.
POS in plain English.
Choose a primary care provider (PCP). Get referrals for in-network specialists. Can see out-of-network providers, but at higher cost and with higher deductibles. Premiums sit between HMO and PPO.
Best for:
Trade-offs to know:
Carriers offering POS plans.
Cost range: $150–$460/mo after subsidies. Your agent compares total cost across all available carriers in your ZIP.
Twelve minutes, scripted.
We'll lay out exactly what your agent will ask, in what order, and why - so you know what to have in front of you before you pick up the phone.
A licensed agent picks up
No phone tree, no transfers, no hold music. Median answer time: 38 seconds.
They ask your ZIP and the ages of anyone covered
So they can pull plans actually available in your state - and confirm the right metal tier for your household.
They ask which doctors and meds matter to you
So they can rule out plans that don't include your providers or formulary. This is the step the marketplace skips.
They show you 3–5 plans side-by-side
Premium, deductible, max out-of-pocket, network size, and a plain-English read on what each gets you.
You pick - they enroll you on the call
Same call. Effective date is typically the 1st of next month. Confirmation by email and SMS within an hour.
You hang up insured
No follow-up sales calls, no info sold to anyone. If you change your mind, we have a 30-day support window - same agent.
You pay nothing. Ever.
We're paid a flat commission by the carrier when you enroll - the same amount whether you pick a BlueCross PPO or an Ambetter HMO. We have zero incentive to push you toward anything but the plan that fits. We don't sell your information. We don't email you for weeks.
Common questions about POS plans.
Both cover out-of-network care. POS requires a PCP and referrals for in-network specialists; PPO doesn't. PPOs offer more flexibility but cost more.
Both use a PCP and referral system. POS adds partial out-of-network coverage that HMOs don't offer. POS costs slightly more.
Yes, but they're less common than PPO and HMO. Availability depends on your state and ZIP. Your agent checks what's offered.
Yes — POS plans are fully subsidy-eligible. About 4 out of 5 enrollees qualify.
Only if you specifically need both a PCP structure and occasional out-of-network access. For most people, a PPO (more flexibility) or HMO (lower cost) is a better fit. Your agent compares all three.
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Your agent compares POS total cost across 6+ carriers. One call, $0 fee.
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