Which plan is described as a hybrid model allowing limited out-of-network care?

• A. Health Maintenance Organization (HMO)
• B. Exclusive Provider Organization (EPO)
• C. Point of Service (POS) Plan
• D. Medicare

Answer: (C)

Point of Service plans blend features of HMO and PPO care. You typically have a primary care physician and may need referrals to see specialists, which helps keep costs down and care coordinated. At the same time, you can go outside the network for services, but with higher cost-sharing and less favorable coverage than in-network care. This hybrid approach—networked care with the option of limited out-of-network access—fits the description.

HMO plans usually cover only in-network care with no out-of-network option, so they aren’t the hybrid described. EPO plans generally don’t cover out-of-network care at all except in emergencies, which isn’t the hybrid model. Medicare is a government program with its own structure, not a private hybrid plan.