Which healthcare plan is payable with out-of-network coverage?

• A. Health Maintenance Organization (HMO)
• B. Point-of-Service (POS)
• C. Coinsurance
• D. Third-Party Payor

Answer: (B)

Out-of-network coverage is a feature of the plan type that blends elements of network protections with the option to go outside the network. Point-of-Service plans let you see either in-network or out-of-network providers. You typically pay lower costs when you stay in-network, but you can receive services outside the network as well, though at higher out-of-pocket costs and with additional rules. The other options don’t fit this concept: an HMO generally requires staying in-network with little to no out-of-network coverage; coinsurance is a cost-sharing feature, not a plan type; and a third-party payor is the payer, not a plan that determines network rules. So the plan that is payable with out-of-network coverage is Point-of-Service.