Arizona Life and Health Practice Exam

Which type of insurance plan typically offers lower premiums for associated healthcare services?

1. Indemnity Plan

2. Exclusive Provider Organization (EPO)

3. Health Maintenance Organization (HMO)

4. Medicare Supplement Plan

The correct answer is: Health Maintenance Organization (HMO)

A Health Maintenance Organization (HMO) plan is known for offering lower premiums for associated healthcare services, primarily because it emphasizes preventive care and requires members to choose a primary care physician (PCP). This structure allows for better management of patient care and reduces overall costs for the insurer. HMOs typically cover services only when provided by in-network doctors and facilities, which helps control healthcare expenses and results in lower premium rates compared to other types of plans. In contrast, indemnity plans generally allow for greater flexibility in choosing healthcare providers, leading to higher costs as members can seek services from any healthcare entity, which tends to drive up premiums. Exclusive Provider Organizations (EPOs) share some characteristics with HMOs but usually offer less restrictive provider networks, which can result in higher costs. Medicare Supplement Plans, designed to cover gaps in Medicare coverage, are also generally not associated with lower premiums as they provide additional benefits that come with higher costs for those enrollees. Therefore, the structure and cost-management strategies of HMOs make them the choice for lower premium rates among healthcare insurance options.