MackeyHIT2Insurance
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What health insurance plan is sponsored by a large company who forms a contract with certain health agencies to provide certain types of health care at reduced rates? | Preferred provider organization or PPO
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If a person has 80/20 co-insurance, what percent does the insurance company pay? | 80%
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What health insurance plan used to be known as CHAMPUS? | TRICARE
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Complete this sentence – Managed care networks are required to provide quality care at the: | Lowest possible cost.
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For what type of Medicare must the consumer pay a premium and an initial deductible for services? | Type B
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John must pay $10 for each visit to his physician. What term describes the $10 payment? | Co-payment
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What do the initials PPO stand for? | Preferred provider organization
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What is the disadvantage of belonging to an HMO? | Required to use only HMO affiliated providers
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What kind of health insurance would someone who is self-employed usually have? | Private health insurance
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What do the initials HMO stand for? | Health maintenance organization
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Kayla has been receiving social security for two years and now has a disability. What federal insurance is she eligible for? | Medicare
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What kind of insurance covers a worker who is injured on the job? | Worker’s compensation
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What happens if a person who belongs to an HMO goes to see a doctor who is not affiliated with his HMO? | The person pays the entire cost of the doctor visit.
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If you work for a company with a group insurance plan, who usually pays all or part of the premium? | The company
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What approach to controlling rising health care costs requires a second opinion before the company will pay for surgery? | Managed care
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What health insurance plan is funded by the U.S. government for military personnel and their families? | TRICARE
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When someone uses Medicare to pay for health care services, what percent does the individual pay? | 20%
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Who administers Worker’s Compensation – local governments, the state, the federal government, or private industry? | The state
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A person who is blind is eligible for what type of state-administered medical assistance program? | Medicaid
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Indemnity | simply means protection, as by insurance, from liabilities or penalties incurred by one's actions.
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Managed Care | It refers to the control that an insurance company or other payer exerts over the physician selection and reimbursement process.
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Self-insurance | An alternative to purchasing an insurance policy.
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Flexible Benefits Account | It provides the individual with a savings account, usually through payroll deduction, into which a set amount can be deposited routinely.
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Champus | Provides care for military dependents and retired member of the armed service.
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Insurance plans fall into one of two basic categories: | indemnity and managed care.
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