Ecn Chapter 11

A "good" health insurance plan pays at least ______ percent of out-of-hospital expenses once a yearly deductible for the individual and family have been met. Multiple choice question.

80

What are some of the factors that have led to increasing health care costs?

An increased number of crimes and accidents The use of expensive technologies

A good health insurance policy provides which of the following?

At least $1 million lifetime maximum for each family member. A stop-loss provision so the policyholder will pay no more than $6,000 out of pocket a year.

Name an independent, nonprofit membership corporation that provides protection against the cost of hospital care:

Blue Cross

Which of the following are common questions for evaluating a disability income policy?

Does the policy cover accident and illness? What percent of income does the benefits pay? How is disability defined?

True or false: Administration costs for health care in the United States are less than in nations such as Canada and Mexico.

False

____is the process of paying a premium in exchange for financial protection.

Insurance

What program was designed to provide medical assistance to low-income individuals and families?

Medicaid

Which insurance supplements Medicare by filling the difference between Medicare payments and medical costs not covered by Medicare?

Medigap insurance

A group of doctors and hospitals that agree to provide health care to members at prearranged fees is called____

PPO

Which of the following is not true about hospital expense coverage?

These policies pay all costs of being hospitalized with no limits.

Health insurance is one way people protect themselves against economic losses due to illness, accident, or disability.

True

Healthfinder includes links to more than 1,600 websites operated by government and nonprofit organizations.

True

The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986 requires employers to offer employees and dependents, who would otherwise lose group health insurance, the option to continue their group health coverage for:

a certain amount of time.

Which of the following factors has not been attributed to increasing health care costs?

a focus on healthy living options

Health insurance is one way people protect themselves against economic losses due to

accident disability illness

Similar to car and life insurance, the individual pays a specified_____ for health insurance in exchange for some degree of financial assurance.

amount

A good disability plan would pay you when you

are unable to work your regular job can only work part-time at your regular job

If your health insurer has denied coverage for medical care you received, you have the right to____ the claim decision

challenge

A provision under which the insured pays a flat dollar amount each time a covered medical service is received is called:

copayment

____ ______ insurance provides regular cash income lost by employees as a result of an accident or illness.

disability income

Which insurance provides payments to replace income when an insured person is unable to work for a long period of time?

disability income insurance

The Patient Protection and Affordable Care Act bans insurance companies from _____ coverage when they get sick.

dropping people from

The federal Consolidated Omnibus Budget Reconciliation Act of 1986 requires many employers to offer group health benefits to:

employees and dependents who would normally lose group health insurance.

Administrative costs in the United States are much higher than those in other nations due to activities such as:

enrolling beneficiaries in a health plan. paying health insurance premiums. filing reimbursement claims. checking eligibility.

By exercising, not smoking, getting rest, and driving carefully, individuals can greatly reduce their ______

health care costs

____ allow you to contribute money to a tax-free account that can be used for out-of-pocket health care expenses if you buy high-deductible health insurance policies to cover catastrophic expenses.

health savings accounts (HSAs)

____ compiles websites from nonprofits, federal and local websites, and many other sources to present a complete health website that ranks 21st among consumers Internet-wide.

healthfinder

Health savings accounts allow you to contribute money to a tax-free account that can be used for out-of-pocket health care expenses if you buy___deductible health insurance policies to cover catastrophic expenses.

high

Rising hospital care costs, new medical technology, and the increasing number of elderly people have helped make____ one of the fastest-growing areas of the health care industry. Multiple choice question.

home health providers

Blue Cross is an independent, nonprofit membership corporation that provides protection against the cost of____care

hospital

The added use of technology, use of prescription drugs, life expectancy of the elderly, and accidents and crimes all lead to _____health care costs.

increased

An_______ policy provides specified benefits regardless of whether the actual expenses are greater or less than the benefits. A______ policy provides benefits based on the actual expense.

indemnity, reimbursement

____term care insurance describes assistance for people who are unable to care for themselves.

long

With disability plans, the longer the waiting period, the ___ the premiums

lower

Prepaid health plans that provide comprehensive health care to members are called____

managed care

_____was designed to provide medical assistance to groups or categories of persons who are eligible to receive payments under one of the cash assistance programs.

medicaid

____ insurance makes up the difference between Medicare payments and medical costs not covered by providing supplemental insurance that can be purchased.

medigap

The reasons for the increased need for home health care include_____

older U.S. population new medical technology rising hospital costs

Self-insurance is an arrangement in which a company collects premiums from employees and

pays medical benefits as needed

Managed care refers to _____ health plans that provide comprehensive health care to members.

prepaid

Key provisions in the Patient Protection and Affordable Care Act of 2010 include

prohibiting lifetime caps on coverage providing tax credits for small businesses to make employee coverage affordable banning companies from dropping people when they get sick

Key provisions in the Patient Protection and Affordable Care Act of 2010 include

providing tax credits for small businesses to make employee coverage affordable prohibiting lifetime caps on coverage banning companies from dropping people when they get sick

Which policy provides benefits based on the actual expense incurred?

reimbursement

The first thing you should do if your health coverage claim has been denied is to:

review your policy

The main risk involved with a____ health plan is the financial burden if the medical bills are greater than the amount covered by premium income.

self-funded

A preferred provider organization (PPO) is a group of doctors and hospitals that agree to provide health care to members at_____ fees that are slightly higher than those for health maintenance organizations.

set

Disability income insurance may also be provided by your employer, Social Security, or

worker's compensation