Unit 16: Medical Expense Plans Flashcards
1
Q
fee for service plans
A
provider is paid as services are provided- customers called insureds
2
Q
prepaid plans
A
provider is paid a a set fee in advance–costumers called subscribers/participants
3
Q
specified coverage
A
covers only specific services
4
Q
comprehensive care
A
covers broad range of services
5
Q
benefit schedule
A
pays only specified amount regardless of the actual charge
6
Q
Usual, customary, reasonable (UCR)
A
pays full charge if reasonable and customary in the same geographical area
7
Q
basic hospital, medical, and surgical policies
A
the original medical expense plans
no out of pocket expenses
low coverage amounts
no deductibles
