Managed Care

Question 1

Point Of Servicd (POS)

Answer 1

Requires PCP
Requires Referrals
Does not usually require pre authorization but if it does PCP does it
Do pay out of network and need PCP referral

Question 2

Preferred Provider Organization (PPO)

Answer 2

Does not require PCP
Does not require referrals
Requires pre authorization
Do pay out of network

Question 3

Exclusive Provider Organization (EPO)

Answer 3

Does not require PCP
Does not require referrals
Requires pre authorization
Do not pay out of network

Question 4

Medicare Part A

Answer 4

Inpatient hospital care
Skilled nursing facilities
Home healthcare
Hospice services

Question 5

Medicare Part B

Answer 5

Outpatient hospital care
Durable medical equipment
Physicians services
Other medical services

Question 6

Medicare Part D

Answer 6

Prescription drug plan at a reduced cost

Question 7

Health Maintenance Organizations (HMOs)

Answer 7

Require PCPs
Require referrals
Don’t usually require pre authorization but if they do the PCP does it
Do not pay to go out of network