Chapter 6: Financing & Reimbursement Methods

An individual who had a hip replacement surgery received separate bills for each individual services such as an admission kit, surgeon fees, operating room fees, anesthesia fees, lab fees, etc, is an example of bundled payments method.

False

For health insurance purposes, the threshold for full-time work under the Affordable Care Act is 36 hours per week.

False

Medicare Part D eliminates the need for Medigap coverage for Medicare beneficiaries.

False

Medicare is designes specifically for three categories of people. Those with chronic heart disease are specifically covered.

False

Risk is generally predictable for insurance underwriters.

False

Supply-side rationing has been used by the United States to control the rising cost of health caused by moral hazards and povider- induced demand.

False

The United States has publicly financed heath insurance specifically for the unemployed.

False

The majority of total US health care expenditure isfinanced by governement.

False

The Rand Health Insurance Experiment demonstrated that utilization could be lowered through cost sharing.

True

The United States does not have publicly financed health insurance specifically for the unemployed.

True

The purpose of a stop-loss provision in a health insurance plan is to limit total out-of-pocket costs.

True

Under Medicare Part A, a beneficiary can have an unlimited number of benefit periods.

True

Health care insurance enables consumers to use more health care services than they would if they had to pay the entire price out of their own pocket.

True

Self insurance refers to large employers who assume risks and budget for medical claims.

True

Health care financing includes purchasing health insurance and paying for the services delivered to insured patients.

True