Chapter 2: Health Insurance Providers Flashcards
Which of the following types of organizations are prepaid group health plans, where members pay in advance for the services of participating physicians and hospitals that have agreements
Health Maintenance Organization HMO
A 66 year old is covered under a group health plan while employed with a business that has 40 employees. If she injures herself while walking in the park, what coverage would be considered primary?
Her group health plan
The situation in which a group of physicians are salaried employees and conduct business in an HMO facility is called an
Closed panel
Which of these is considered a true statement regarding medicaid?
funded by state and local governements
Which of the following organizations would make reimbursement payments directly to the insured individual for covered medical expenditures?
Commercial insurer
Which of the following does SS NOT provide benefits for?
dismemberment
Which type of provider is known for stressing preventative medical care and routine physical examinations?
Health Maintenance organization HMO
A medical care provider which typically delivers health services at its own local medical facility is known as a:
Health Maintenance Organization HMO
Which of these statements is INCORRECT regarding a Preferred Provider Organization PPO?
PPO’s normally have more providers to chose from as compared to an HMO
Prices are negotiated in advance for PPO providers
**PPO’s are NOT a type of manager care systems
Which of the following statements is true about most BCBS organizations
They are nonprofit organizations
Which of the following BEST describes how a PPO is less restrictive than a HMO
more physicians to choose from
What is the maximum SS Disability benefit amount an insured can receive?
100% of the insured Primary Insurance Amount
What does medicare parts A and B cover?
Part A covers hospitalization; Part B covers doctor’s services
What is Medicare?
A hospital and medical expense insurance program
Which of the following reimburses its insureds for covered medical expenses?
commercial insurers
