2 - Health Insurance Providers

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

Health Maintenance Organizations (HMO's)

Which of the following BEST describes how a Preferred Provider Organization (PPO) is less restrictive than a Health Maintenance Organization (HMO)?

More physicians to choose from

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

They are nonprofit organizations

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

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

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

Health Maintenance Organization

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

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

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

Medicare is intended for all of the following groups EXCEPT

Those enrolled as a full-time student

The situation in which a group of physicians are salaried employees and conduct business in an HMO facility is called a(n)

closed panel

Medicare Part A and Part B do NOT pay for

dental work