Chapter 2

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?

health maintenance organization

what is the maximum social security disability benefit amount an insured can receive

100% of the insured's primary insurance amount

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

health maintenance organization

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

HMOs

which of these statements is INCORRECT regarding a preferred provider organization

PPO's are NOT a type of managed care system

what does medicare parts A and B cover?

Part A covers hospitalization; Part B covers doctor's services

Medicaid was designed to assist individuals who are

below a specific income limit

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

closed panel

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

commercial insurer

which of the following reimburses its insureds for covered medical expenses

commercial insurers

medicare part A and part B do NOT pay for:

dental work

which of the following does social security NOT provide benefits for

dismemberment

which of these is considered a true statement regarding Medicaid

funded by both state and federal governments

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

health maintenance organization

Which type of provider is known for stressing preventative medical care?

health maintenance organizations

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

what is medicare

is a hospital and medical expense insurance program

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

medicaid

which of the following BEST describes how a preferred provider organization is less restrictive than a health maintenance organization

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

ppo

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

primary care physician

the percentage of an individual's primary insurance amount determines the benefits paid in which of the following programs

social security disability income

which of the following statements is true about most Blue Cross/Blue Shield organizations

they are nonprofit organziations

medicare is intended for all of the following groups EXCEPT

those enrolled as a full-time student