Praxis 5857 Practice Question
Which of the following is a health insurance plan that allows a person to see a within-network doctor for a low copayment or an out-of-network doctor for a reimbursed percentage of the cost of the visit?
Correct Answer: D
Rationale: A Point-of-Service (POS) plan combines features of both HMO and PPO plans, allowing members to choose between in-network and out-of-network providers. When seeing an in-network doctor, members enjoy lower copayments, while out-of-network visits are reimbursed at a percentage, offering flexibility.
A Preferred Provider Organization (PPO) does allow out-of-network visits, but typically does not require a primary care physician and may have higher costs associated with out-of-network care. A Health Maintenance Organization (HMO) restricts members to a network of doctors and requires referrals for specialists, limiting flexibility. Traditional health insurance programs often lack the structured network and copayment options seen in POS plans.
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