Arkansas Insurance Adjuster Practice Exam

Which of the following statements regarding primary care physicians is FALSE?

1. Preferred Provider Organizations do not allow policyholders to choose a primary care physician.

2. Major Medical Plan policyholders can choose any primary care physician they like.

3. Point of Service Plans allow a policyholder to select his own primary care physician.

4. A primary care physician must approve all medical procedures for policyholders in a Health Maintenance Organization

The correct answer is: Preferred Provider Organizations do not allow policyholders to choose a primary care physician.

A possible explanation could be The statement in option A is false because Preferred Provider Organizations (PPOs) do allow policyholders to choose their own primary care physician. PPOs offer more flexibility compared to Health Maintenance Organizations (HMOs) in terms of provider choice. With a PPO, policyholders can visit any doctor or specialist within the network without needing a referral or approval from a primary care physician. Option B is also incorrect as Major Medical Plans typically require policyholders to choose a primary care physician, although they may have more options to choose from than in an HMO. Option C is correct as Point of Service Plans (POS) do allow policyholders to select their own primary care physician, although they may need to pay a higher cost if they see a provider outside of the network. Finally, option D is incorrect as a primary care physician is not required to approve all medical procedures for policyholders in an HMO. While HMOs do often require a referral from a primary care physician to see a specialist, they do not necessarily need approval for all procedures. Overall, it is important to understand the differences between these types of health insurance plans and their varying levels of flexibility in choosing a primary care physician.