Which health plan allows members to choose their own physicians and hospitals?

Study for the Pima JTED Sports Medicine Test. Enhance your skills and knowledge with comprehensive quizzes, flashcards, and explanations. Be exam-ready today!

The Preferred Provider Organization (PPO) is designed to offer members greater flexibility in choosing their healthcare providers. Members of a PPO are not restricted to a network of providers, which means they can see any doctor or specialist, without requiring a referral, and they have the option to receive care from out-of-network providers, albeit often at a higher cost. This model contrasts with other health plans like HMOs, which typically mandate that members select a primary care physician and restrict them to a network of providers, requiring referrals for specialist services.

The flexibility of the PPO model appeals to individuals who value the ability to make their own healthcare choices and may have specific doctors or hospitals they wish to continue using. It's important to note that while EPOs and POS plans also offer some level of provider choice, they do not provide the same degree of flexibility as PPOs. EPOs limit coverage to in-network providers and do not allow out-of-network care, except in emergencies, whereas POS plans combine features of both HMOs and PPOs but typically still require referrals to see specialists within the network.

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