Which statement is true regarding in-network provider services?

The statement that HMO POS plans only cover in-network services is accurate because Health Maintenance Organization (HMO) plans typically emphasize the use of network providers, which helps to control costs and ensure quality of care. While HMO plans generally provide limited or no coverage for services rendered by out-of-network providers, a Point of Service (POS) plan adds some flexibility by allowing members to seek care outside of the network, though usually at a higher cost. In this context, stating that HMO POS plans only cover in-network services implies an understanding that these plans have a primary focus on in-network providers, aligning with their design to encourage coordinated care and manage overall expenses.

Understanding this structure is crucial for individuals enrolled in such plans, as using out-of-network providers can result in higher out-of-pocket costs and may require prior authorization. Therefore, members should thoroughly understand the terms of their specific plan to make informed decisions about their healthcare usage.