Chapters 5 and 6 ( Health insurance Providers & Medical Expense)

Question 1

Blue Cross / Blue Shield

Answer 1

Pre-paid plans payed to the doctors and physicians. Therefore making blue cross / blue shield a none profit.

Question 2

PPO’s Preferred Provider Organizations

Answer 2

Service is not provided on the pre-payment bases. (Co-Payments and Deductibles) fee for service

Question 3

Medicare A covers ____ Medicare B covers ____

Answer 3

1. Hospital Expenses
2. Doctor Services
   Dental not covered

Question 4

Social Security Disability

Answer 4

Waiting period of 5 months.

Question 5

MEWA Multiple Employer Welfare Arrangements

Answer 5

Tax exempt entities (501c)

Question 6

Basic Medical Expense “First Dollar Insurance”

Answer 6

Usually only covers in hospital care.

Question 7

Health Savings Account

Answer 7

Tax deductible contributions (must contribute to a high deductible health plan to qualify)

Question 8

Hospital Indemnity

Answer 8

An amount paid out for the insured while hospitalized at a set amount and time (Daily, Weekly, or Monthly)

Question 9

Surgical Expenses (location)

Answer 9

Usually coverage is given even if the care was given in or out or hospital

Question 10

Corridor Expense

Answer 10

Covers the gap between basic and major coverage. Only applied when basic medical expense is exhausted.

Question 11

Health reimbursement arrangement

Answer 11

Must be established by employer. Employee does not contribute to HRA

Question 12

MSA Medical Savings Account

Answer 12

Created to pay medical expenses of smaller groups of employees, Max: 50 ppl