What responsibility does a "Closed Panel" health plan impose on its members?

A "Closed Panel" health plan is designed to streamline care and control costs by requiring its members to utilize a specific network of healthcare providers. This means that members are limited to accessing services only from the providers that are part of the plan’s network. The intention behind this structure is to create a more coordinated and managed approach to healthcare, helping to ensure that the members receive care that is consistent with the plan's guidelines and cost-effective.

Because members are restricted to these designated providers, they generally need to seek care within this closed system, which can lead to lower out-of-pocket costs for services received. This requirement helps the insurance company manage overall healthcare costs while ensuring that members receive care that meets certain quality benchmarks.

The other choices revolve around flexibility and decision-making in healthcare that is not characteristic of a "Closed Panel" health plan. Specifically, the inability to choose any provider or self-refer to specialists is a significant factor distinguishing these plans from more open options, such as Preferred Provider Organization (PPO) plans where broader provider access is allowed.