Which plan is described as a hybrid option that requires selecting a primary care physician and obtaining referrals, and is abbreviated POS?

• A. Health maintenance organization (HMO)
• B. Preferred provider organization (PPO)
• C. Exclusive provider organization (EPO)
• D. Point of service plan (POS)

Answer: (D)

Point of service plans blend features of two common types. They operate like a traditional HMO in that you typically choose a primary care physician who coordinates your care and, for many specialist visits, you’ll need a referral. That keeps care coordinated and costs predictable. But they also include PPO-like flexibility: you can opt to receive care from out-of-network providers, usually with higher out-of-pocket costs and different coverage levels. So this plan is described as hybrid because you get the PCP gatekeeper and referral process, while still having the option to go out of network.

Other options don’t fit this exact mix. An HMO emphasizes a PCP and referrals with little to no out-of-network coverage. A PPO lets you see specialists without referrals and offers broad out-of-network coverage without the gatekeeper model. An EPO provides care only from in-network providers and typically doesn’t offer out-of-network benefits, also without requiring referrals. The defining hybrid feature of requesting both a PCP referral structure and some out-of-network option points to a Point of Service plan.