Which term is a health insurance plan that covers the cost of providers within a network and outside of the network, although copayments by the patient are higher for out-of-network providers?

Which term is a health insurance plan that covers the cost of providers within a network and outside of the network, although copayments by the patient are higher for out-of-network providers?

• A. Premium
• B. Exclusive Provider Organizations (EPOs)
• C. Blue Cross and Blue Shield
• D. Preferred Provider Organization (PPOs)

Answer: (D)

Think about a plan that gives you the most choice in providers while still offering cost savings for in-network care. This describes a Preferred Provider Organization. You pay lower copays and receive negotiated rates when you stay in-network, but you can still see out-of-network providers if you’re willing to pay higher copayments and coinsurance. This flexibility is what sets it apart from stricter plans. A premium is just the monthly fee for coverage, not the network structure. Exclusive Provider Organizations typically don’t cover out-of-network care (except emergencies), so they don’t fit the description. Blue Cross and Blue Shield is a brand that offers many plan types, not a single plan type.

Think about a plan that gives you the most choice in providers while still offering cost savings for in-network care. This describes a Preferred Provider Organization. You pay lower copays and receive negotiated rates when you stay in-network, but you can still see out-of-network providers if you’re willing to pay higher copayments and coinsurance. This flexibility is what sets it apart from stricter plans. A premium is just the monthly fee for coverage, not the network structure. Exclusive Provider Organizations typically don’t cover out-of-network care (except emergencies), so they don’t fit the description. Blue Cross and Blue Shield is a brand that offers many plan types, not a single plan type.