Question

Point of Service Plans a type of HMO/PPO hybrid. They encourage plan members to seek but are not required to use a primary care provider who will become the gatekeeper of services. Members will receive lower fees if they use a gatekeeper model.

Answer 1

The missing part of the question is if the statement is true or false.

It is true.

Step-by-step explanation:

In an HMO (health maintenance organization) plan you select a primary care physician, who is your gatekeeper. This person will take care of your health and give you referrals to see a specialist or to run tests on you. Your referral is to a provider with your HMO network, if you see a doctor outside this network or without a referral, you have to pay all costs by yourself.

PPO (preferred provider organization) is a health care plan where it is not necessary to have a primary care physician, there are different professionals in your network, and you can see them without a referral or a previous appointment with your physician first. As long as you see professionals with your PPO network, you will pay cheaper fees, but if you choose to see a doctor that is not with your PPO network, you will have to pay more expensive fees.

In conclusion, members of HMO/PPO can use the plan or not, but if they do, they will pay lower fees.