Which managed care plan covers services only from in-network providers, requires no PCP referrals for specialists, and often has lower premiums?

• A. Exclusive Provider Organization
• B. Health Maintenance Organization
• C. Preferred Provider Organization
• D. Point of Service

Answer: (A)

This type of plan is defined by a network-restricted approach with lower cost and direct access to specialists. An Exclusive Provider Organization covers services only when you stay within its in-network providers, and you typically don’t need a primary care physician to refer you to a specialist. Because the plan limits coverage to a specific network and reduces the administrative steps of coordinating care, premiums tend to be lower than plans that offer broader networks or require referrals.

Think of it as choosing a specific group of providers you’re guaranteed to work with, with fewer barriers to see a specialist, but with no coverage if you go outside that group. That combination—network-only coverage, no PCP referrals, and lower premiums—best matches the described plan. The other options either require a PCP and referrals (HMO), allow out-of-network coverage with higher costs (PPO), or mix features with varying referral rules (POS), so they don’t fit all three conditions.