QUESTION IMAGE
Question
8 which type of insurance plan allows the subscriber to seek discounted medical treatment from doctors who have agreed to provide services at a discounted rate?
preferred provider organization plan
point of service plan
health maintenance organization plan
traditional healthcare plan
Analyze the question stem
The question asks for the type of insurance plan that allows subscribers to seek discounted medical treatment from a network of doctors who have agreed to provide services at a discounted rate.
Evaluate the options
Using the Managed Care Plans knowledge point
- Preferred Provider Organization (PPO) plan: This plan features a network of "preferred" providers who contract with the insurer to provide services at pre-negotiated, discounted rates. Subscribers can see these in-network doctors for lower out-of-pocket costs without needing a primary care physician referral.
- Point of Service (POS) plan: This plan combines elements of HMOs and PPOs, requiring a primary care physician referral for specialists but allowing out-of-network care at higher costs.
- Health Maintenance Organization (HMO) plan:
Using the Health Maintenance Organization knowledge point
This plan restricts coverage to care from doctors who work for or contract with the HMO, usually requiring a primary care physician referral and not focusing primarily on a broad "preferred provider" discounted network structure.
- Traditional healthcare plan: Also known as indemnity plans, these allow subscribers to see any doctor, and the insurer pays a set percentage of the fee, without pre-negotiated network discounts.
Select the correct option
The description matches a Preferred Provider Organization (PPO) plan.
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- (A) Preferred Provider Organization plan (Correct answer)
- (B) Point of Service plan
- (C) Health Maintenance Organization plan
- (D) Traditional healthcare plan