Chapter 2: Health Insurance Providers

which of these is considered a true statement regarding medicaid

funded by both state and federal governments

What is maximum social security disability benefit amount an insured can recieve

100% of the PIA

Medicaid was designed to assist individuals who are

Below a specific income limit

who reimburses the insured for covered medical expenses

Commercial

which of the following does social security NOT provide benefits for

Dismemberment

A medical care provider which typically delivers health services at its own local medical facility is known as a

HMO

J is a subscriber to a plan which contracts with doctors and hospitals to provide medical benefits at a preset price. What type of plan does J belong to?

HMO

which of the following types of organizations are prepaid group health plans, where members pay in advance for the services of partipating physicians and hospitals that have agreements

HMO

which type of provide is known for stressing preventative medical care and routine physical examinations

HMO

Which of the following best describes how PPO is less restrictive then HMO

More physicians to choose from

Under what system do a group of doctor and hospitals in a designated area contract with an insurer to provide services at a prearranged cost to insured

PPO

which of these statements is incorrect regarding a preferred provider organization

PPOs are not a type of managed care systems

what does medicare pat a and part b cover

Part A covers hospitalization Part B covers doctors services

the % of an individuals PIA determines the benefits paid in which of the following benefits

Social Security disability income

which of the following statements is true about most blue cross/blueshield organizations

They are non profit organizations

what is medicare

a hospital and medical expense insurance program

the situation in which a group of physicians are salaried employees and conduct business in an HMO facility is called

closed panel

which of the following organizations would make reimbursement payments directly to the insured individual for covered medical expenditures

commercial insurer

Medicare Part A and Part B do NOT pay for

dental work

a 66 year-old is covered under a group health plan while employed with a business that has 40 employees. if she injures herself while walking in the park, what coverage would be considered primary

her group health plan

the health insurance program which is administered by each state and funded by Both the federal and state governments is called

medicaid

the individual who provides general medical care for a patient as well as the referral for specialized care is known as a

primary care physican

medicare is intended for all of the following groups, except

those enrolled as a full time student