chapter2 intro to health ins & healthcare

Question 1

insurance

Answer 1

contract that protects the insured from loss

Question 2

Insurance company

Answer 2

guarantees payment to insured for an unforeseen event

Question 3

Premium

Answer 3

mount the insured pays to an insurance company for coverage

Question 4

Other types of insurance

Answer 4

automobile, disability, liability, malpractice,
property, life

Question 5

Managed health care

Answer 5

or managed care) (delivery of benefits and services
through contracted arrangements

Question 6

Health care insurance

Answer 6

s a more traditional form of reimbursing
health care costs and involves a contract between a policyholder and a third-party
payer or government health program

Question 7

Managed health care

Answer 7

focuses on cost management (or cost
containment), utilization, and quality by delivering health plan benefits through
contracted arrangements between individuals or health care programs and
managed care organizations (MCOs). MCOs accept a predetermined per member
per month (capitation) payment for services

Question 8

advantage of health insurance

Answer 8

is the availability of providers for care, while
managed care can provide cost savings. A disadvantage of health insurance is it
can be costly, while managed care may limit the availability of providers in a
service area.

Question 9

Private health insurance

Answer 9

66.5%

Question 10

Private health insurance

Answer 10

17.8%

Question 11

Medicare

Answer 11

18.4%

Question 12

Military health care

Answer 12

3.7%

Question 13

Group health insurance

Answer 13

Coverage subsidized by employers and other organizations

Distributes cost of health insurance among group members

Question 14

Individual health insurance

Answer 14

Private health insurance policy purchased by individuals or families who do not have
access to group health insurance coverage

Question 15

Public health insurance

Answer 15

Federal and state government health programs

• Include Medicare, Medicaid, CHIP, and TRICARE

Question 16

Single-payer plan

Answer 16

• National health service model adopted by some Western nations
• Funded by taxes
• Government pays for residents’ health care as a basic social service

Question 17

Socialized medicine

Answer 17

• Single-payer health system
• Government owns and operates health care facilities
• Government pays providers their salaries

Question 18

Universal health insurance

Answer 18

• Social insurance model with goal of providing every individual with access to health
  coverage, regardless of the system implemented
• Combination of private and public health insurance
• Example: PPACA of 2010 extended health coverage to millions of uninsured
  Americans by (originally) requiring them to purchase health insurance

Question 19

Health Insurance Coverage Statistics

Answer 19

that 106.4 percent of
people in the United States are covered by some form of health insurance.

hat is because some are covered by more than one health insurance
plan and they are counted more than once when percentages are calculated