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A Point-of-Service (POS) health plan is best described as:
a.A hybrid that blends HMO features with the option to go out of network at a higher cost
b.A pure fee-for-service indemnity plan with no network
c.A plan that provides no coverage outside a fixed network under any circumstances whatsoever
d.A plan identical in every way to a standard HMO
Giải thích
A POS plan combines HMO and PPO characteristics: members typically choose a primary care physician and use the network for the lowest cost, but they may also go outside the network at the point of service by paying more. It is not a pure indemnity plan, not identical to an HMO (it allows out-of-network use), and it does provide some out-of-network coverage. The 'point of service' name reflects that the member decides in or out of network each time care is needed.
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Câu hỏi liên quan cùng chủ đề
- A managed care 'preauthorization' (precertification) requirement means the insured or provider must:
- Under a 'capitation' payment arrangement, an HMO pays a network physician:
- In an HMO, the primary care physician often serves as a 'gatekeeper,' which means the physician:
- Many disability income policies include a waiver of premium feature that:
- Under a 'guaranteed renewable' health policy, the insurer:
- A 'conditionally renewable' policy allows the insurer to decline renewal:
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Người kiểm duyệt John Zihao Zhang — California-Licensed Life Insurance Agent (CA Dept. of Insurance License #4396095 — kiểm tra)