What is a key feature of an HMO?

What is a key feature of an HMO?

• A. Requires a PCP for coordinated care.
• B. Offers no network restrictions.
• C. Is funded by per-service payments.
• D. A prepaid plan that typically requires a Primary Care Physician for coordinated care.

Answer: (D)

In an HMO, care is delivered through a fixed network and is paid for on a prepaid basis, with a primary care physician acting as the gatekeeper who coordinates all your care and referrals. This setup keeps costs predictable and emphasizes preventive, coordinated care within the network. That prepaid, coordinated-care model is why the best description combines both elements: a prepaid plan plus the requirement for a primary care physician to coordinate care. The other statements miss key features of HMOs: they do operate within a network and rely on a capitation-style prepaid arrangement rather than paying per service, and they do not offer unrestricted, no-network-access.

In an HMO, care is delivered through a fixed network and is paid for on a prepaid basis, with a primary care physician acting as the gatekeeper who coordinates all your care and referrals. This setup keeps costs predictable and emphasizes preventive, coordinated care within the network.

That prepaid, coordinated-care model is why the best description combines both elements: a prepaid plan plus the requirement for a primary care physician to coordinate care. The other statements miss key features of HMOs: they do operate within a network and rely on a capitation-style prepaid arrangement rather than paying per service, and they do not offer unrestricted, no-network-access.