Chapt 16 Health Ins. Providers

HMOs are known for stressing
A. preventive medicine and early treatment
B. state-sponsored health care plans
C. in-hospital care and services
D. health care services for government employees

Which of the following organizations would make reimbursement payments directly to the insured individual for covered medical expenditures?
A. Administrative-services-only plan
B. Commercial insurer
C. Preferred provider organization
D. Health maintenance organization

Marty just received his first Social Security disability payment. From this, we can assume
A. he had previously applied for Medicaid
B. he is at least 65 years of age
C. his disability is expected to last at least 12 months
D. his disability commenced 3 months ago

Which of the following statements pertaining to health maintenance organizations is correct?
A. An insurance company that also markets group health insurance is known as an HMO
B. If a person joins an HMO and undergoes a physical examination, she will be billed for the exam and each subsequent medical service as it is performed.
C. An insurance company may sponsor an HMO or assist an HMO by providing contractual services.
D. Like commercial insurers, HMO's generally assess deductibles

The waiting period before qualifying for Social Security disability benefits is how many months?
A. 3
B. 5
C. 6
D. 12

Which of the following individuals would probably qualify for Social Security disability benefits?
A. George, a ski instructor who breaks his leg
B. Carl, who becomes ill with a viral infection and is not expected to be able to work for the next 6 months
C. Mike, a mechanic who loses his dominant hand in an accident
D. John, who experiences serious early-onset Alzheimer's and is unable to remember how to get to work

Which of the following statements pertaining to Medicaid is not correct?
A. It provides a federal matching funds to states for medical public assistance plans
B. Its purpose is to help eligible needy persons with medical assistance
C. Medicaid benefits may be used to pay the deductible and coinsurance amounts of Medicare.
D. It limits financial assistance to persons are 65 or over who are in need of medical services they cannot afford

Jerry is injured while working. Under state worker's compensation laws, we can assume that
A. his employer will not be liable for Jerry's work-related disabilities of the employee's negligence did not contribute to the injuries
B. Jerry will probably receive workers' compensation benefits on a monthly or weekly basis
C. Jerry must sue his employer to receive workers' compensation benefits
D. both Jerry and his employer are required to contribute to the cost of workers' compensation coverage