Which of the following health plans typically requires a primary care physician to coordinate care?

Prepare for the Arkansas Health Insurance Exam with flashcards and multiple choice questions, each question features hints and detailed explanations. Ensure your success!

A Health Maintenance Organization (HMO) plan typically requires members to select a primary care physician (PCP) who is responsible for coordinating all of the patient’s healthcare needs. This includes providing referrals to specialists and managing overall care, ensuring that patients receive the appropriate treatment within the network. The coordination by the PCP is a key feature of HMO plans, which aim to streamline care and reduce costs by emphasizing preventive services and requiring network usage.

In contrast, fee-for-service plans allow patients the freedom to visit any healthcare provider without the need for a primary care physician's approval. This means patients can seek care from specialists directly without referrals. Preferred Provider Organizations (PPOs) also offer greater flexibility, enabling members to see any healthcare provider, although they benefit financially from using a network of preferred providers. Short-term health insurance does not typically involve coordination of care, focusing instead on providing basic coverage for a limited duration without the same network or care coordination structure found in HMOs.

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