Which plan contracts with medical providers to form a network of participating providers and offers lower costs for in-network care without requiring referrals?

• A. A PPO that contracts with medical providers to form a network and has no required referrals.
• B. A plan that restricts provider access to a single facility and always requires referrals.
• C. A plan that covers only dental services.
• D. A plan with no network and full-price billing.

Answer: (A)

This describes a Preferred Provider Organization (PPO) plan. A PPO contracts with a network of medical providers, which allows members to receive lower costs when they stay in-network. It also typically does not require referrals to see specialists, giving you more flexibility to choose who you see. You can still go out of network, but at higher costs and with less coverage, which emphasizes the benefit of staying in-network.

The other options don’t fit because one describes a plan that confines you to a single facility and always requires referrals (that’s more like an HMO with gatekeeping), another describes a plan that covers only dental services (a dental plan), and a plan with no network and full-price billing (an indemnity or traditional fee-for-service plan).