Which of the following best describes an example of a Health Maintenance Organization (HMO)?

The correct choice illustrates a fundamental characteristic of Health Maintenance Organizations (HMOs), which require members to select a primary care physician (PCP). The PCP acts as the first point of contact for health services and plays a crucial role in managing patient care, including providing referrals to specialists when necessary. This model promotes coordinated care and helps control costs by encouraging members to use in-network providers and avoid unnecessary services.

Understanding the structure of HMOs is crucial: members typically must obtain referrals from their PCP to see specialists, which manages patient flow within the network and ensures oversight of care continuity. This system contrasts with plans that allow unrestricted access to any specialist without prior approval, which is not typical of HMOs.

The other options present features that do not align with the standard operational model of an HMO. A plan covering medical expenses for out-of-state hospitals does not reflect the usual limitations and network restrictions seen in HMOs. Similarly, unrestricted access to specialists without a primary care referral is characteristic of different types of health insurance plans, like Preferred Provider Organizations (PPOs), where patients have more flexibility in choosing their healthcare providers. Lastly, a plan providing health services without any restrictions also does not exemplify the structured approach of an HMO, which is designed to