Final answer:
Maria's care from an out-of-network provider is likely covered by her PPO plan, albeit with higher out-of-pocket costs than in-network coverage. PPOs offer greater flexibility than HMOs, but subscribers pay more for going outside the network.
Step-by-step explanation:
If Maria is a Preferred Provider Organization (PPO) subscriber and has received care from an out-of-network provider, the likely result is that the care is covered, but with higher out-of-pocket costs compared to in-network services. PPO plans generally offer the flexibility to visit providers outside of their network, but subscribers may face a higher deductible or co-insurance rate for out-of-network services. In addition, the full cost of the service may not be covered, which means Maria is responsible for paying the difference between the amount the PPO will reimburse and the healthcare provider's charges.
Moreover, PPOs function differently from Health Maintenance Organizations (HMOs), which typically require you to stay within network or get a referral from a primary care physician before seeing a specialist. The nature of PPO plans partially protects against the risk of adverse selection and moral hazard, by sharing costs between the insurer and the insured, thereby encouraging more responsible use of healthcare services.