Which features best describe an HMO plan?

• A. More flexibility to see any doctor anywhere
• B. No referrals needed for specialty care
• C. A plan that covers only hospital services
• D. Requires using in-network providers and referrals, with lower premiums

Answer: (D)

HMOs rely on coordinated care through a primary care physician who acts as your gatekeeper. You usually must use in-network providers to receive covered services, and you generally need a referral from your PCP to see a specialist. This structure helps keep costs down, so HMOs typically offer lower premiums and lower out-of-pocket costs, but with less flexibility to see providers outside the network.

The best description among the options is the one that notes using in-network providers and referrals, along with lower premiums, because it captures the gatekeeper model, network limitation, and cost savings that define HMOs.

Other options describe features typical of different plans: more freedom to see any doctor is characteristic of a PPO; no referrals for specialty care aligns with open-access or PPO plans; a plan that covers only hospital services does not reflect an HMO’s broader coverage.