What type of plan allows enrollees to see out-of-network providers but with higher costs?

Prepare for the North Carolina Medicare Supplement and Long-Term Care Agent Test with flashcards and multiple-choice questions. Each comes with hints and explanations. Ace your exam confidently!

The type of plan that allows enrollees to see out-of-network providers, albeit at a higher cost, is a Point-of-Service (POS) plan. These plans combine features of Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). With a POS plan, members are typically required to choose a primary care physician and would receive the highest level of benefits if they see in-network providers.

However, unlike HMOs, where care is generally restricted to network providers, POS plans offer the flexibility to seek care from out-of-network providers. This comes with a trade-off—members will incur higher out-of-pocket costs when opting for services outside their network. This balance between flexibility and cost is a defining feature of POS plans, making them distinct from other types of managed care plans that have more limited options.

Indemnity plans, on the other hand, allow for greater freedom in choosing providers without the need to see a primary care doctor first and typically do not restrict members to networks. Exclusive Provider Organizations (EPOs) restrict coverage to a network of providers but do not offer options for out-of-network services at higher costs. Therefore, the key characteristic of a POS plan is its allowance for out-of-network providers with the understanding

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