HCD 330 COMPREHENSIVE EXAMINATION ON U.S.
HEALTHCARE SYSTEMS, INSURANCE MECHANISMS, PUBLIC
HEALTH, AND PATIENT CARE QUESTIONS WITH VERIFIED
ANSWERS
1. Which cost-sharing mechanism is the payment that patients must pay at the
point of service?
A) Premium
B) Deductible
C) Copayment
D) Coinsurance
Correct Answer: C
2. Which part of Medicare covers both hospital and physician services through
what is known as Medicare Advantage Plans?
A) Part A
B) Part B
C) Part C
D) Part D
Correct Answer: C
3. Which statement best defines the term Formulary?
A) A list of covered healthcare providers
B) A list of medications covered by the insurance company
C) A schedule of patient copayment amounts
D) A directory of in-network hospitals
Correct Answer: B
,4. Which cost-sharing mechanism is a set amount that the insured (or insured's
employer) pays on a monthly basis in order to maintain membership in an
insurance plan?
A) Copayment
B) Deductible
C) Premium
D) Coinsurance
Correct Answer: C
5. Which statement best describes Health insurance risk-sharing?
A) Each member pays only for their own medical costs
B) Members enroll in group insurance plans and pool money through monthly
premium payments. The pooled money covers medical costs across all members
so that risk is spread across all members.
C) The government covers all medical costs for high-risk individuals
D) Insurance companies assume all financial risk without member contributions
Correct Answer: B
6. Which statement best represents the way hospitals negotiate prices with
Medicare?
A) Hospitals can negotiate prices individually with Medicare
B) Hospitals negotiate prices through state intermediaries
C) Hospitals can not negotiate with Medicare and must accept the Medicare set
reimbursement rates
D) Hospitals set their own prices and Medicare reimburses 80%
Correct Answer: C
7. The majority of insured Americans get their health insurance through which
type of system?
A) Direct government purchase (Medicare)
B) Employer-based insurance
C) Individual marketplace plans
D) Medicaid
Correct Answer: B
, 8. Medicare reimburses physician services based on which of the following
methods?
A) DRGs (Diagnosis Related Groups)
B) Capitation per patient
C) RVUs (Relative Value Units), or fee-for-service based on a relative value
assigned to the physician's service (also called RBRVs)
D) Salary-based compensation
Correct Answer: C
9. Which cost-sharing mechanism is the amount that must be paid by the
patient prior to the insurance paying for services rendered?
A) Copayment
B) Premium
C) Coinsurance
D) Deductible
Correct Answer: D
10. Select the categories of people who may be eligible for Traditional Medicaid
(select ALL correct answers).
A) Pregnant women
B) Single childless adults
C) People with disabilities
D) The elderly
E) Families with dependents
Correct Answers: A, C, D, E
11. The federal government pays a larger portion of costs associated with the
Medicaid Expansion program (when compared to states).
A) True
B) False
Correct Answer: A
12. Which part of Medicare covers physician expenses?
A) Part A
B) Part B
HEALTHCARE SYSTEMS, INSURANCE MECHANISMS, PUBLIC
HEALTH, AND PATIENT CARE QUESTIONS WITH VERIFIED
ANSWERS
1. Which cost-sharing mechanism is the payment that patients must pay at the
point of service?
A) Premium
B) Deductible
C) Copayment
D) Coinsurance
Correct Answer: C
2. Which part of Medicare covers both hospital and physician services through
what is known as Medicare Advantage Plans?
A) Part A
B) Part B
C) Part C
D) Part D
Correct Answer: C
3. Which statement best defines the term Formulary?
A) A list of covered healthcare providers
B) A list of medications covered by the insurance company
C) A schedule of patient copayment amounts
D) A directory of in-network hospitals
Correct Answer: B
,4. Which cost-sharing mechanism is a set amount that the insured (or insured's
employer) pays on a monthly basis in order to maintain membership in an
insurance plan?
A) Copayment
B) Deductible
C) Premium
D) Coinsurance
Correct Answer: C
5. Which statement best describes Health insurance risk-sharing?
A) Each member pays only for their own medical costs
B) Members enroll in group insurance plans and pool money through monthly
premium payments. The pooled money covers medical costs across all members
so that risk is spread across all members.
C) The government covers all medical costs for high-risk individuals
D) Insurance companies assume all financial risk without member contributions
Correct Answer: B
6. Which statement best represents the way hospitals negotiate prices with
Medicare?
A) Hospitals can negotiate prices individually with Medicare
B) Hospitals negotiate prices through state intermediaries
C) Hospitals can not negotiate with Medicare and must accept the Medicare set
reimbursement rates
D) Hospitals set their own prices and Medicare reimburses 80%
Correct Answer: C
7. The majority of insured Americans get their health insurance through which
type of system?
A) Direct government purchase (Medicare)
B) Employer-based insurance
C) Individual marketplace plans
D) Medicaid
Correct Answer: B
, 8. Medicare reimburses physician services based on which of the following
methods?
A) DRGs (Diagnosis Related Groups)
B) Capitation per patient
C) RVUs (Relative Value Units), or fee-for-service based on a relative value
assigned to the physician's service (also called RBRVs)
D) Salary-based compensation
Correct Answer: C
9. Which cost-sharing mechanism is the amount that must be paid by the
patient prior to the insurance paying for services rendered?
A) Copayment
B) Premium
C) Coinsurance
D) Deductible
Correct Answer: D
10. Select the categories of people who may be eligible for Traditional Medicaid
(select ALL correct answers).
A) Pregnant women
B) Single childless adults
C) People with disabilities
D) The elderly
E) Families with dependents
Correct Answers: A, C, D, E
11. The federal government pays a larger portion of costs associated with the
Medicaid Expansion program (when compared to states).
A) True
B) False
Correct Answer: A
12. Which part of Medicare covers physician expenses?
A) Part A
B) Part B
