Which plan offers coverage for out-of-network care without a referral?

Which plan offers coverage for out-of-network care without a referral?

• A. PPO
• B. HMO
• C. EPO
• D. HDHP

Answer: (A)

PPO plans let you see any licensed provider and don’t require referrals to see specialists. You can receive coverage for out-of-network care, though you’ll pay higher deductibles and coinsurance when you use it. This flexibility distinguishes PPOs from other plan types, which typically restrict you to in-network care or require referrals. HMOs usually require staying in-network and getting a referral for specialists, while many EPOs cover only in-network care (with limited exceptions like emergencies). An HDHP describes deductible and cost-sharing, not network access or referral rules. So the option that offers out-of-network coverage without a referral is the PPO.

PPO plans let you see any licensed provider and don’t require referrals to see specialists. You can receive coverage for out-of-network care, though you’ll pay higher deductibles and coinsurance when you use it. This flexibility distinguishes PPOs from other plan types, which typically restrict you to in-network care or require referrals. HMOs usually require staying in-network and getting a referral for specialists, while many EPOs cover only in-network care (with limited exceptions like emergencies). An HDHP describes deductible and cost-sharing, not network access or referral rules. So the option that offers out-of-network coverage without a referral is the PPO.