MOA Unit 7 Lesson 1

Preventive care is:

• a set schedule of visits to the doctor for early detection of illness.

• maintaining a healthy lifestyle to avoid injury or illness.

• a surgery to remove the risk of a particular disease.

• a service or procedure performed with the goal of avoiding future injury or illness.

What is an insurance carrier?

• A contract between a patient and an insurance company

• A company that provides insurance plans (Correct Answer)

• A hospital that accepts patients with insurance

• A person who has insurance coverage

Which type of managed care plan requires that patients use an in-network provider?

• Point of Service Plan (POS)

• Health Maintenance Organization (HMO)

• Preferred Provider Organization (PPO)

How often must a patient meet the deductible?

• Every two years

• Each month

• Each year

• Only once

What is the goal of managed care insurance?

• To create more medical facilities

• To increase medical care options for all patients

• To promote alternative medical treatments

• To reduce medical expenses

If an individual is enrolled in an insurance plan through a benefits package at work, what kind of enrollment is this?

• Individual

• Group

Which of the following is an advantage of choosing a fee-for-service plan?

• The patient can receive care from any provider.

• The premiums are lower than for managed care plans.

• The patient does not have to pay a deductible.

• A coinsurance payment is not required.

Which of the following represents the health insurance carrier’s agreement to provide benefits for covered services and will pay for those services based on guidelines?

• An insurance policy

• An employment agreement

• An insurance contract

• A health exam

With fee-for-service plans, patients are reimbursed for healthcare expenses after out-of-pocket payments are made.

• True

• False

Which type of managed care plan generally reimburses physicians using capitation?

• Preferred Provider Organization (PPO)

• Point of Service Plan (POS)

• Health Maintenance Organization (HMO)