Which plan may require a PCP but typically doesn't need referrals?

Which plan may require a PCP but typically doesn't need referrals?

• A. HMO
• B. PPO
• C. EPO
• D. Indemnity

Answer: (C)

The plan type shown blends gatekeeping with direct access within a network. In this setup you may be asked to designate a primary care physician who coordinates your care, but you can usually see network specialists without needing a referral. That combination is why this option fits: it can require a PCP, yet it typically doesn’t require referrals to see specialists as long as you stay in-network. For contrast, an HMO always requires a PCP and referrals for specialists, a PPO generally doesn't require a PCP or referrals and gives broad self-referral access within the network, and a traditional indemnity plan lets you see any provider with less emphasis on referrals.

The plan type shown blends gatekeeping with direct access within a network. In this setup you may be asked to designate a primary care physician who coordinates your care, but you can usually see network specialists without needing a referral. That combination is why this option fits: it can require a PCP, yet it typically doesn’t require referrals to see specialists as long as you stay in-network.

For contrast, an HMO always requires a PCP and referrals for specialists, a PPO generally doesn't require a PCP or referrals and gives broad self-referral access within the network, and a traditional indemnity plan lets you see any provider with less emphasis on referrals.