Midterm Part 5 Flashcards
Which program pays for inpatient hospital critical care access, skilled nursing facility stays, hospice care, and some home health care?
A. Medicare Part A
B. Medicare Part D
C. Medicare Part C
D. Medicare Part B
Medicare Part A
Which type of health insurance coverage is subsidized by employers and other organizations?
A. Universal health insurance
B. Public health insurance
C. Individual health insurance
D. Group health insurance
Group health insurance
Which of the following services has the highest likelihood of being a “covered service”?
A. Pe-existing condition
B. Medically unnecessary
C. Medically necessary
D. Cosmetic
Medically necessary
A physician hospital organization (PHO) is owned by hospital(s) and physician groups that obtain managed care plan contracts. The physicians _______ and provide health care services to plan members.
A. Maintain their own practices
B. Purchase the PHO building
C. Are employed by PHO
D. Calculate what they want to earn
Maintain their own practices
All of the following are types of episode-of-care reimbursement except:
A. Global payment
B. Capitation
C. Prospective payment
D. Self-insured plan
Self-insured plan
Which provides coverage for catastrophic or prolonged illnesses and injuries?
A. Health insurance marketplace
B. Indemnity health plan
C. State mandated benefits
D. Major medical insurance
Major medical insurance
TRUE/FALSE: Medicare part D enrollment is automatic.
False
When does a Medicare patient start having to pay a copayment amount during a benefit period?
A. For 90 days and beyond of hospitalization
B. For the first 30 days of hospitalization
C. For days 61-90 of hospitalization and beyond
D. For the first 60 days of hospitalization
For days 61-90 of hospitalization and beyond
What government agency administers the Medicaid and Medicare programs?
A. HCFA
B. DHHS
C. SSA
D. CMS
CMS
The patient protection and affordable care act (PPACA) was signed into federal law on March 23, 2010 and resulted in the creation of a health insurance marketplace to:
A. Allow Americans to purchase health coverage that fits their budget and meets their needs
B. Replace other health insurance programs, such as private insurance
C. Create the Obama care federal national health insurance program
D. Requires employers to offer group health insurance to all employers
Allow Americans to purchase health coverage that fits their budget and meets their needs
