Which plan is commonly designed to provide flexibility by allowing out-of-network care at higher costs while maintaining an in-network option?

Which plan is commonly designed to provide flexibility by allowing out-of-network care at higher costs while maintaining an in-network option?

• A. EPO
• B. PPO
• C. HMO
• D. HDHP

Answer: (B)

This describes a plan design that offers broad provider choice with cost penalties for non-network care but keeps the option to use in-network providers at lower costs. A Preferred Provider Organization allows you to see any licensed provider, including out-of-network ones, but you’ll pay higher cost-sharing when you go out of network. You still have the option to use in-network providers, which have negotiated lower rates and typically lower cost-sharing. The other plan types tend to restrict network use or structure costs differently: some require staying in-network with little to no out-of-network coverage, some require a primary care physician to coordinate care, and some rely on a high deductible with less emphasis on network flexibility.

This describes a plan design that offers broad provider choice with cost penalties for non-network care but keeps the option to use in-network providers at lower costs. A Preferred Provider Organization allows you to see any licensed provider, including out-of-network ones, but you’ll pay higher cost-sharing when you go out of network. You still have the option to use in-network providers, which have negotiated lower rates and typically lower cost-sharing. The other plan types tend to restrict network use or structure costs differently: some require staying in-network with little to no out-of-network coverage, some require a primary care physician to coordinate care, and some rely on a high deductible with less emphasis on network flexibility.