Chapter 2: Health

Which of the following BEST describes how a Preferred Provider Organization (PPO) is less restrictive than a Health Maintenance Organization (HMO)? Typically not subject to deductibles Not regulated by the federal government More benefits available More physicians to choose from

More physicians to choose from

Under what system do a group of doctors and hospitals in a designated area contract with an insurer to provide services at a prearranged cost to the insured? HMO PPO EPO PLHSO

PPO

Medicare is a disability program is a hospital and medical expense insurance program offers assistance in making health insurance premiums Part D provides payment for surgeon expenses

is a hospital and medical expense insurance program

What is the maximum Social Security Disability benefit amount an insured can receive? 50% of the insured's Primary Insurance Amount (PIA) 75% of the insured's Primary Insurance Amount (PIA) 100% of the insured's Primary Insurance Amount (PIA) 100% of the insured's Primary Insurance Amount (PIA) minus any monies received from a retirement plan

100% of the insured's PIA

Which of the following organizations would make reimbursement payments directly to the insured individual for covered medical expenditures? Administrative-services-only plan Commercial insurer Preferred provider organization Health maintenance organization

Commercial insurer

Medicare Part A and Part B do NOT pay for. dental work hospitalization skilled nursing care physical therapy

Dental work

The individual who provides general medical care for a patient as well as the referral for specialized care is known as a Physician's assistant Primary Care Physician Secondary Care Physician Third Party Administrator

Primary care physician

The percentage of an individual's Primary Insurance Amount (PIA) determines the benefits paid in which of the following programs? Social Security Disability Income Medicare Supplements Medicaid COBRA

Social Security Disability Income

Medicare is intended for all of the following groups EXCEPT Those enrolled as a full-time student Those receiving Social Security disability benefits for at least 24 months Those afflicted with chronic kidney failure Those 65 and older

Those enrolled as a full-time student

The situation in which a group of physicians are salaried employees and conduct business in an HMO facility is called a(n) closed panel open panel co-op panel capitation panel

closed panel