A patient is upset because her health insurance plan refused to pay for a mammogram and services by a women's health specialist because the primary care physician did not order the referral or the mammogram.Which type of insurance plan adheres to this type of payment system?

Question

Quizplus · Accepted Answer

Health Maintenance Organizations (HMOs) typically require a referral from a primary care physician before they will cover services by specialists or specific tests like mammograms. This is part of their managed care system, designed to control costs by ensuring that such services are medically necessary.

A Patient Is Upset Because Her Health Insurance Plan Refused