What type of plan can be either network-based or non-network-based?

Disable ads (and more) with a membership for a one time $4.99 payment

Prepare for the United Healthcare Certification Exam. Use our resources to enhance your understanding with detailed questions and answers. Master the exam content with confidence!

The correct response to the question regarding the type of health plan that can be either network-based or non-network-based is a Private Fee-for-Service (PFFS) plan. PFFS plans are unique in that they allow members to receive care from any Medicare-approved provider, meaning they do not have a predetermined network of providers that members must use. This flexibility enables PFFS participants to see any provider willing to accept the plan's payment terms.

In contrast, Health Maintenance Organizations (HMOs) typically require members to use a network of providers and obtain referrals for specialty services, thus limiting their options to in-network healthcare professionals. Preferred Provider Organizations (PPOs) provide more choice than HMOs but still have an established network that members can choose from, although they can go outside of the network at a higher cost. Point of Service (POS) plans combine elements of HMOs and PPOs, requiring members to choose a primary care provider and allowing some out-of-network coverage, but they are still based on a specified network of providers.

Therefore, the flexibility of the PFFS plan to operate independently of a network is what distinguishes it as being either network-based or non-network-based.