1. A point-of-service (POS) plan combines features of:

HMO and PPO plans, letting members choose in- or out-of-network at the time of care

A POS plan blends HMO and PPO features, letting the member choose network or out-of-network care when service is needed.

2. In a managed care plan, the primary care physician acting as a gatekeeper:

Coordinates care and authorizes referrals to specialists

The gatekeeper primary care physician coordinates care and authorizes referrals to specialists.

3. Capitation is a payment method in which a provider is paid:

A fixed amount per member per month regardless of services used

Under capitation a provider receives a fixed amount per member per month regardless of services used.

4. A prescription drug formulary is:

A list of drugs the plan covers, often by tier

A formulary is the plan's list of covered drugs, frequently organized into cost tiers.