Unit 16: Medical Expense Plans Flashcards

1
Q

fee for service plans

A

provider is paid as services are provided- customers called insureds

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2
Q

prepaid plans

A

provider is paid a a set fee in advance–costumers called subscribers/participants

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3
Q

specified coverage

A

covers only specific services

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4
Q

comprehensive care

A

covers broad range of services

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5
Q

benefit schedule

A

pays only specified amount regardless of the actual charge

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6
Q

Usual, customary, reasonable (UCR)

A

pays full charge if reasonable and customary in the same geographical area

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7
Q

basic hospital, medical, and surgical policies

A

the original medical expense plans
no out of pocket expenses
low coverage amounts
no deductibles

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