Ch. 9 Skills Check

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

An aging population An increased number of uninsured individuals The cost of prescription drugs

What qualifications must you have to be eligible for Medicare?

Be under age 65 with certain disabilities Be 65 or older

Which two groups pay the majority of the nation's health care bill, leading to a lack of incentives to cut down on costs?

Government Private health insurers

Which of the following is a provision of the Patient Protection and Affordable Care Act? Does not penalizes individuals if they do not purchase health insurance Requires new private plans to cover preventive services with high copayment and high deductibles Requires health insurance companies to submit justification for all requested premium increases Requires employers with more than 100 employees to provide health insurance to their employees or pay penalties

Requires health insurance companies to submit justification for all requested premium increases

The sources of disability income coverage include worker's compensation, employer group insurance plans, and _______ Security.

Social

What are the sources of disability income coverage?

Social Security Employer plans Worker's compensation

Managed care is offered by which of the following? Multiple select question. a. Health maintenance organizations b. Preferred provider organizations c. Point-of-service plans d. Any government agency e. Point-of-care plans

a, b, c

A "good" health insurance policy provides which of the following? Multiple select question. a. Limit your out-of-pocket expenses to no more than $2,000 to $3,000 per year, excluding dental, vision care, and prescription costs b. Pay at least 80 percent of out-of-hospital expenses after a yearly deductible of $1,000 per person or $2,000 per family c. Offer basic coverage for hospital and doctor bills d. At least 60 days' hospital room and board in full

b, c

A combination of hospital expense insurance, physician expense insurance, and surgical expense insurance is called:

basic health insurance

A provision under which the insurer and insured share the covered losses (for example, you pay 25 percent) is called:

coinsurance

__________ income insurance provides regular cash income when an insured person is unable to work because of pregnancy, a non-work-related accident, or an illness.

disability

HMO basic health services include inpatient, outpatient, maternity, mental health, substance abuse rehabilitation, and ________ care.

emergency

A health maintenance organization (HMO) is a health insurance plan that provides a wide range of health care services for a(n) ________ monthly premium.

fixed prepaid

Most private insurance companies are providers of ________ health insurance policies through employers.

group

A health insurance plan that provides a wide range of health care services for a fixed prepaid monthly premium is called a:

health maintenance organization (HMO)

Blue Cross is an independent, nonprofit membership corporation that provides protection against the cost of ___________ care.

hospital

Comprehensive major medical insurance policies are complete insurance policies offering a very _______ deductible.

low/cheap

___________ medical expense insurance pays the large costs involved in long hospital stays and multiple surgeries, and it covers every type of care and treatment prescribed by a physician, in and out of a hospital.

major

Prepaid health plans that provide comprehensive health care to members are called:

managed care

A network of selected contracted participating providers, also called an HMO-PPO hybrid, is a:

point-of-service plan

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

prepaid

Preventive care for an HMO includes checkups, screening, testing, and routine ______.

shots/vaccinations

_________ health services for an HMO include vision and prescription services.

supplemental or extra

Blue Shield is an independent, nonprofit membership corporation that provides benefits for _________ and medical services performed by physicians.

surgical