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WorksheetsHealthcare Organizational Structure and Insurance
Total questions: 20
Worksheet time: 10mins
What was the Baylor Plan, and who was it originally created for?
A private plan for wealthy business owners
A nationwide insurance policy for military families
A government program for farmers in the 1930s
A prepaid insurance plan for Dallas schoolteachers in 1929
Which major insurance organizations grew directly out of the Baylor Plan?
Health Maintenance Organizations (HMOs)
Medicare and Medicaid
Red Cross and Doctors Without Borders
Blue Cross and later Blue Shield
What is the main purpose of an organizational structure in a healthcare facility?
To outline responsibilities and ensure smooth operations
To limit communication between staff
To increase patient costs
To reduce the number of staff members needed
Why is it important for healthcare employees to know the organizational structure of their workplace?
So they can avoid following rules
So they know who to report to and how responsibilities are organized
So they know what to wear
So they know where to park
Which is a federal insurance program for people 65+
Medicare
Medicaid
CHIP
TRICARE
If a doctor is in-network, what does that mean for the patient?
The cost is usually lower
The doctor works for the government
The insurance company refuses to pay
The patient can’t see that doctor
Which government insurance program is designed for low-income families?
Medicare
Medicaid
Workers’ Compensation
PPO
Which plan provides care for military members and their families?
Workers’ Compensation
Medicaid
Medicare
Tricare
What does co-pay mean?
A percentage of the medical cost you must pay
The monthly amount you pay for insurance
A fixed dollar amount you pay for a healthcare service (like $20 for a doctor visit)
The total amount you pay in a year
What is the main purpose of health insurance?
To make hospitals richer
To help pay the cost of healthcare services
To avoid going to the doctor
To guarantee free healthcare
What is a deductible?
The cost of a prescription
The fixed amount you pay for each doctor visit
The amount you must pay before your insurance starts to help cover costs
The total amount of medical bills in a year
Which type of insurance requires you to have a Primary Care Provider (PCP) who gives referrals for specialists?
PPO (Preferred Provider Organization)
HMO (Health Maintenance Organization)
Medicare
CHIP
What does out-of-pocket maximum mean?
The average cost of health insurance
The total bill from your doctor
The monthly premium
The most you pay for healthcare in one year
As discussed in class, what does the term organization mean?
A building with many rooms
A rule book for employees
A chart showing responsibilities
An organized body of people with a particular purpose
Employer-based insurance
Federal insurance program for people 65+
Insurance offered through a workplace.
Government program providing coverage for children in families who earn too much for Medicaid but can’t afford private insurance.
Government program for active duty military and their families
Healthcare providers that contract with your insurance company for lower costs.
In-network provider
Out-of-network provider
Workers' Compensation
Life insurance
A medical condition that existed in the patient before he/she received insurance coverage
Pre-existing condition
Referral
Beneficiary
Premium
Measures taken to prevent disease and injuries rather than curing them or treating symptoms
Preventative care
Pre-existing condition
Treatment
Co-insurance
Percentage of medical costs you are responsible for after you have met your deductible
Co-insurance
Co-payment
Referral
Premium
Affordable Care Act (ACA) or Obama Care was signed into law in 2010 with a goal to make health insurance available to everyone and includes which of these standards:
Insurers can not deny coverage or charge higher rates for individuals with pre-existing health conditions.
Children get kicked off their parents plan at age 21
Plans cover whatever they want
