Mrs. Tanner is enrolled in a Medicare Advantage HMO that offers a point of service option. This allows Mrs. Tanner to do which o
f the following? Answer is either: can go to non-plan doctors for certain services without receiving prior approval or can go to non-plan doctors without prior approval for all services
Mrs. Tanner is allowed in some situations to visit out-of-network doctors without needing prior authorization.
Explanation:
For HMOs with a point of service feature, members may be permitted to see doctors outside the plan under specific conditions without advance approval. Although most services are delivered by in-plan providers, this point of service benefit applies mainly in emergencies, urgent care when outside the service area, and out-of-area dialysis. An example includes obtaining screening mammograms.
She ought to take a moment to breathe and then work towards resolving the issue; if she can't find a solution, she should trace back her steps to her current whereabouts.
