Which type of managed care plan allows self-referral to specialists while requiring a primary care provider?

The Point of Service (POS) Organization is the correct choice because it combines elements of both Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). In a POS plan, members are required to select a primary care provider (PCP) who serves as the main point of contact for healthcare needs. This primary care provider manages referrals to specialists.

What sets POS plans apart is the flexibility they offer when it comes to seeing specialists. Unlike an HMO where a referral from the primary care provider is typically required for any specialist visits, a POS plan allows members to self-refer to specialists, although doing so may incur higher out-of-pocket costs if they do not go through their PCP first. This blend of requiring a primary care provider while maintaining the option for self-referral creates a unique and appealing structure for many consumers seeking balance between care coordination and autonomy in healthcare decisions.

In contrast, HMOs often require strict adherence to referrals from the primary care provider and do not typically allow self-referrals. PPOs allow for more freedom in seeing specialists without requiring a primary care provider’s referral but do not have the same requirement for a designated primary care provider. EPO plans also do not generally permit self-referrals outside of their network and