Question

Understand the difference between exclusive provider organization and point of service providers. is a HMO / PPO hybrid does not cover out of network providers selects a primary care physician costs more to see out of network providers

Answer 1

Answer:

For Exclusive Provider Organization (EPO) the correct answer is: "does not cover out of network providers". In this insurance plan a primary care provider is not necessary, but health care providers should be chosen from a predetermined network. It does not cover out of network providers, and in order to see one, you would require a pre-authorization.

For the Point of Service (POS) the correct answers are: "is a HMO / PPO hybrid", "selects a primary care physician" and "costs more to see out of network providers" . Like a Health Maintenance Organization (HMO), in this type of plan it is necessary to select a primary care provider or physician, but like a Preferred Provider Organization (PPO), the patients could go outside of the network for health care services, however it would cost more

Explanation: