Under what type of plan do beneficiaries pay different rates for in-network versus out-of-network services?

The correct answer is that beneficiaries pay different rates for in-network versus out-of-network services under a Point of Service (POS) plan. A POS plan combines features of both Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs).

Within a POS plan, members have the flexibility to choose their healthcare providers. They receive the highest level of benefits when they use network (in-network) providers, typically resulting in lower out-of-pocket costs. However, if they decide to go outside of the network to see an out-of-network provider, they can do so but will pay higher rates. This structure incentivizes patients to utilize in-network services while still providing the option to seek care outside the network with additional costs.

Other plan types differ in their approach. For instance, HMO plans generally require members to choose a primary care physician and obtain referrals to see specialists, with little to no coverage for out-of-network services. PPOs do allow members to see any provider without needing a referral, but they often provide higher reimbursement levels for in-network services compared to out-of-network care. Fee-for-Service plans allow beneficiaries to receive care from any provider and typically reimburse a set fee for services rendered, without necessarily distinguishing between in-network and out-of