Which plan allows a patient to choose an HMO or non-HMO provider but requires a deductible for non-HMO visits?

Which plan allows a patient to choose an HMO or non-HMO provider but requires a deductible for non-HMO visits?

• A. EPO
• B. HMO
• C. PPO
• D. POS

Answer: (D)

Point-of-Service plans blend features of HMOs and PPOs. You can receive care from in-network providers with lower costs, similar to an HMO, or you can go outside the network for more flexibility, like a PPO. When you choose a non-network (out-of-network) visit, benefits are tied to a deductible, and you’ll typically face higher cost-sharing. This setup—the option to pick HMO or non-HMO providers with a deductible applying to out-of-network visits—is what defines a POS plan. EPO and HMO plans stay strictly in-network or use gatekeeping, while PPOs emphasize out-of-network freedom without the same deductible-for-out-of-network structure.

Point-of-Service plans blend features of HMOs and PPOs. You can receive care from in-network providers with lower costs, similar to an HMO, or you can go outside the network for more flexibility, like a PPO. When you choose a non-network (out-of-network) visit, benefits are tied to a deductible, and you’ll typically face higher cost-sharing. This setup—the option to pick HMO or non-HMO providers with a deductible applying to out-of-network visits—is what defines a POS plan. EPO and HMO plans stay strictly in-network or use gatekeeping, while PPOs emphasize out-of-network freedom without the same deductible-for-out-of-network structure.