Which plan allows seeing specialists without referrals?

Which plan allows seeing specialists without referrals?

• A. HMO
• B. PPO
• C. HDHP
• D. EPO

Answer: (B)

Direct access to specialists without a referral is a feature of PPO plans. In a PPO, you can go straight to a specialist without needing your primary care physician to authorize the visit. You still save money by staying in-network, but you have the option to see out-of-network providers at higher out-of-pocket costs as well. This flexibility sets PPOs apart from plans that use a gatekeeper model. For example, HMOs typically require a PCP to refer you to a specialist, and high-deductible plans focus on deductible amounts rather than referral rules. EPOs are network-based and generally limit care to in-network providers. The key idea here is the no-referral access to specialists, which is characteristic of PPOs.

Direct access to specialists without a referral is a feature of PPO plans. In a PPO, you can go straight to a specialist without needing your primary care physician to authorize the visit. You still save money by staying in-network, but you have the option to see out-of-network providers at higher out-of-pocket costs as well. This flexibility sets PPOs apart from plans that use a gatekeeper model. For example, HMOs typically require a PCP to refer you to a specialist, and high-deductible plans focus on deductible amounts rather than referral rules. EPOs are network-based and generally limit care to in-network providers. The key idea here is the no-referral access to specialists, which is characteristic of PPOs.