Chapter Exam - Health Providers

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 is intended for all of the following groups EXCEPT

Those enrolled as a full-time student

Medicare Part A and Part B do NOT pay for

dental work

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 organizations would make reimbursement payments directly to the insured individual for covered medical expenditures?

Commercial insurer

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?

HMO

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

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

Which of these statements is INCORRECT regarding a Preferred Provider Organization (PPO)?

PPO's are NOT a type of managed care systems

What does Medicare parts A and B cover?

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