Which health plan limits coverage to care from doctors, hospitals, and clinics within a specific network and focuses on preventive care, often requiring members to choose a PCP and obtain referrals to see specialists?

• A. Health Maintenance Organization (HMO)
• B. PPO
• C. Health Maintenance Plan (HMO)
• D. Open Access Plan

Answer: (C)

This plan type limits coverage to care from doctors and facilities within a defined network and emphasizes preventive services. Members typically choose a primary care physician who coordinates their care, and referrals are usually required to see specialists. That gatekeeper approach and network restriction fit the Health Maintenance Plan (HMO) description best. While HMOs are often called Health Maintenance Organizations, this option uses the term Health Maintenance Plan, which aligns with the scenario. In contrast, a PPO generally allows out-of-network coverage with higher costs and doesn’t depend on referrals, and an Open Access Plan often offers more direct access to specialists with less gatekeeping, so they don’t match the described referral-focused, network-limited setup as closely.