What type of insurance plan allows insured individuals to choose between in-network or out-of-network providers?

Prepare for the Massachusetts Health and Accident Insurance Exam. Access flashcards, multiple choice questions, hints, and explanations. Be exam-ready!

The option that defines an insurance plan allowing insured individuals to choose between in-network and out-of-network providers is a Point-of-Service Plan. This type of plan blends characteristics of both Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs).

With a Point-of-Service Plan, members are typically encouraged to use a primary care physician for referrals, similar to an HMO. However, they also have the flexibility to seek care from out-of-network providers, which is a hallmark of PPOs. This choice offers enrollees the ability to receive care from a wider range of healthcare professionals, although utilizing out-of-network services often comes with higher costs than in-network services.

This flexibility is essential for individuals who may have specific healthcare needs or prefer particular providers not covered in-network. The design of the Point-of-Service Plan aims to balance cost-effectiveness with patient choice, making it an appealing option for many consumers seeking health insurance.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy