Fair Square Medicare Wordmark

What Is a Medicare Advantage POS Plan?

Cover image

By Daniel Petkevich

May 10, 2023

Is an HMO-POS Plan Right for You?

When navigating the Medicare space, you might encounter several acronyms like HMO, PPO, POS, etc. Sometimes, it can be confusing and difficult to differentiate between these plans.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

But, before choosing which plan best meets your needs and budget, you must understand how their coverage differs.

Let's take a closer look at Medicare Advantage POS plans, so you can decide if it aligns with your healthcare needs.

What's a Medicare Advantage POS Plan?

A Medicare Advantage POS plan, also known as the HMO-POS plan (Health Maintenance Organization-Point of Service) plan, is a health insurance plan that combines the features of both

HMOs and PPOs

(Preferred Provider Organizations).

Like an HMO, this plan usually requires you to choose a

primary care physician

(PCP) who will be the first point of contact for all your healthcare needs, and you may need a referral from your PCP to see a specialist.

However, an HMO-POS plan may offer some out-of-network benefits like a PPO. This means you can see providers outside the plan's network, but you will typically pay more out-of-pocket for these services.

For example, suppose you require specialist care under an HMO-POS plan. In that case, you'll typically need a referral from your primary care physician (PCP) before receiving coverage for the specialist's services. If the specialist is part of your network, your out-of-pocket costs will likely be lower. However, if you decide to see an out-of-network specialist, you'll be covered but will probably pay higher out-of-pocket costs for their services compared to in-network providers.

What's the Difference Between an HMO, PPO and HMO-POS Plan?

‎‎

Pros and Cons of HMO-POS Plans

HMO-POS plans may be a good option if you prefer having a primary care physician (PCP) to coordinate all aspects of your healthcare. It allows for comprehensive care coordination under the guidance of your PCP, leading to a more streamlined and personalized healthcare experience.

Additionally, Medicare HMO-POS plans can offer added convenience if you frequently travel. These plans provide access to out-of-network providers, allowing individuals to receive medical care even when away from home, ensuring peace of mind and continuity of care.

However, before zeroing in on an HMO-POS plan, let's discuss its pros and cons.

Pros of HMO-POS Plans

  • Lower premiums when compared to PPO plans

  • Provides coverage for out-of-network services

  • No deductible for in-network services

Cons of HMO-POS Plans

  • Premiums are higher than an HMO plan

  • Need referrals to see a specialist

  • Higher out-of-pocket costs for out-of-network services

  • They may include a deductible for out-of-network care

  • Additional paperwork is required when using out-of-network care — you'll have to file your claims to get reimbursement

Is a Medicare Advantage POS Plan Right for You?

A Medicare Advantage POS or HMO-POS plan offers greater flexibility than an HMO plan as it covers out-of-network care. However, you may require referrals from your primary care physician to see specialists and may face higher out-of-pocket costs when seeing providers outside your network. Additionally, these plans generally have higher premiums than HMO plans.

If you prefer a PCP and would also like the flexibility of out-of-network services, an HMO-POS plan would be a good option compared to a higher premium PPO plan.

Nevertheless, it's essential to consider all the aspects of the plan and make an informed decision. At

Fair Square Medicare

, we have assisted numerous Medicare beneficiaries in selecting a plan that fits their budget and meets their healthcare needs. If you need help understanding each plan's pros and cons, call us at 888-454-2383. We are here to help.

Speak with a Medicare Advocate

Talk to one of our Licensed Medicare Agents today to find the right plans for you.

Recommended Articles

Cover image

What is Plan J?

Jul 14, 2025

Enroll in Social Security step-by-step with the help of Fair Square stock image

How to Enroll in Social Security

Apr 28, 2023

Last will and testament stock photo

Does Medicare Pay for Funeral Expenses?

Dec 6, 2022

Model of the lungs with the diseased part. Cancer or Ground glass opacity GGO. stock photo

Does Medicare pay for Opdivo?

Nov 23, 2022

COVID-19 at home test stock image

Does Medicare Cover COVID Tests?

Dec 21, 2022

woman in a therapist office stock photo

Does Medicare Cover Hypnotherapy?

Nov 22, 2022

Cover image

Estimating Prescription Drug Costs

May 25, 2020

Diagnosis incontinence stock image

Does Medicare Cover Incontinence Supplies?

Dec 22, 2022

Senior couple going over their finances in front of a computer stock image

How Much Does Medicare Part B Cost in 2025?

Dec 27, 2022

Cover image

2025 Medicare Price Changes

Oct 30, 2023

What is the ICEP?

What is the Medicare ICEP?

Apr 7, 2023

a doctor tells her patient she doesn't accept medicare. the patient wonders what to do stock image

What to Do When Your Doctor Doesn't Take Medicare

Feb 24, 2023

Kidney stone stock image

Does Medicare Cover Kidney Stone Removal?

Nov 23, 2022

Cover image

What People Don't Realize About Medicare

Mar 27, 2023

Vitamin in a syringe stock photo

Does Your Medicare Plan Cover B12 Shots?

Aug 15, 2022

alphabet_soup

How to Choose a Medigap Plan

Jan 10, 2023

Cover image

What Is a Medicare Advantage POS Plan?

May 10, 2023

senior man experiencing discomfort stock image

Does Medicare Cover Linx Surgery?

Dec 6, 2022

More of our articles

13 Best Ways for Seniors to Stay Active in Columbus

13 Best Ways for Seniors to Stay Active in Philadelphia

14 Best Ways for Seniors to Stay Active in Nashville

14 Best Ways for Seniors to Stay Active in Washington, D.C.

15 Best Ways for Seniors to Stay Active in Denver

Building the Future of Senior Healthcare

Can I switch From Medicare Advantage to Medigap?

Can I Use Medicare Part D at Any Pharmacy?

Can Medicare Advantage Plans be Used Out of State?

Can Medicare Help with the Cost of Tyrvaya?

Costco Pharmacy Partners with Fair Square

Denied Coverage? What to Do When Your Carrier Says No

Do Medicare Supplement Plans Cover Dental and Vision?

Does Medicare Cover Air Purifiers?

Does Medicare Cover an FMT?

Does Medicare Cover Bladder Sling Surgery?

Does Medicare Cover Boniva?

Does Medicare Cover Cala Trio?

Does Medicare Cover Cardiac Ablation?

Does Medicare Cover Chiropractic Visits?

Does Medicare Cover Cold Laser Therapy (CLT)?

Does Medicare Cover Compounded Medications?

Does Medicare Cover Disposable Underwear?

Does Medicare Cover ESRD Treatments?

Does Medicare Cover Flu Shots?

Does Medicare Cover Hearing Aids?

Does Medicare Cover Hepatitis C Treatment?

Does Medicare Cover LVAD Surgery?

Does Medicare Cover Medical Marijuana?

Does Medicare Cover Mental Health?

Does Medicare Cover Nexavar?

Does Medicare Cover Penile Implant Surgery?

Does Medicare Cover Service Animals?

Does Medicare Cover Shock Wave Therapy for Plantar Fasciitis?

Does Medicare Cover SI Joint Fusion?

Does Medicare Cover Stair Lifts?

Does Medicare Cover the Urolift Procedure?

Does Medicare Cover Xiafaxan?

Does Medicare Pay for Antivenom?

Does Your Plan Include A Free Gym Membership?

Fair Square Bulletin: We're Revolutionizing Medicare

Fair Square Client Newsletter: AEP Edition

Finding the Best Dental Plans for Seniors

How Do I Sign up for Medicare? A Simple How-To Guide For You

How Do Medigap Premiums Vary?

How Does Medicare Pay for Emergency Room Visits?

How is Medicare Changing in 2025?

How Medicare Costs Can Pile Up

How Much Does a Medicare Coach Cost?

How Much Does a Pacemaker Cost with Medicare?

How Much Does Trelegy Cost with Medicare?

How to Apply for Medicare?

How to Become a Medicare Agent

How to Deduct Medicare Expenses from Your Taxes

Is Balloon Sinuplasty Covered by Medicare?

Is Botox Covered by Medicare?

Is Emsella Covered by Medicare?

Is Vitrectomy Surgery Covered by Medicare?

Medicare & Ozempic

Medicare Advantage Plans for Disabled People Under 65

Medicare Guaranteed Issue Rights by State

Medicare Savings Programs in Kansas

Saving Money with Alternative Pharmacies & Discount Programs

The Fair Square Bulletin: October 2023

Top 10 Physical Therapy Clinics in San Diego

What If I Don't Like My Plan?

What is the 8-Minute Rule on Medicare?

What To Do If Your Medicare Advantage Plan Is Discontinued

What's the Deal with Flex Cards?

What's the Difference Between HMO and PPO Plans?

When Can You Change Medicare Supplement Plans?

Why Is Medicare So Confusing?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.

Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2025

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M