Test Bank For Health Insurance Today, 7th -
2021 All Chapters
define insurance - ANSWER>>the act or business, through legal means, of protecting an
individual's person or property against loss or harm arrising out of specified circumstances in
return for payment
money recieved by insurance company in exchange for protection - ANSWER>>premium
insurance classifies "undesirable events" as - ANSWER>>illness and injury
insurance is derived from - ANSWER>>Latin word securitas, which translates to security in
English
medicare is for - ANSWER>>the elderly
medicaid is for - ANSWER>>the indigent ( those who don't not have the funds to pay for
medical treatment)
deductibles - ANSWER>>amount of covered expenses that must be incurred and paid by the
insured before benefits become payable by the insurance company
HMOs were intended to be low-cost alternatives to - ANSWER>>fee-for-service
group plans - ANSWER>>plans offered by ones employer
health insurance exchanges - ANSWER>>set of government-regulated, standardized plans
eligible for federal subsidies from which individuals can purchase low-cost health insurance
subsidies - ANSWER>>financial assistance
HIPAA - ANSWER>>health insurance portability and accountability act
HIPAA regulation for employer-sponsered group health insurance plans - ANSWER>>required to
accept transfers from other group plans without imposing a preexisting condition clause
2 common state programs for the uninsured - ANSWER>>medicaid and CHIP
, CHIP - ANSWER>>childrens health insurance program
provides care for qualifying children who are ineligble for medicaid but cannot afford private
insurance
graying of america - ANSWER>>life expectancy has increased significantly over the years
healthcare costs rise because elderly typically require more medical care
cost-sharing - ANSWER>>insured individuals pay a portion of the healthcare costs (e.g.
deductibles, coinsurance, copayment)
most covered workers require___ before plan benefits are provided. individuals must pay ___ -
ANSWER>>deductible
copayment or precent of coinsurance per encounter
indemnity plan is also refered to as - ANSWER>>fee-for-service
indemnity plan - ANSWER>>patients can choose any provider or hospital
with indemnity plan, bills are sent - ANSWER>>to the insurance carrier and the patient is
reimbursed according to the rules of the policy
managed healthcare - ANSWER>>plan attempts to control or coordinate use of health services
by its enrolled
patients see designated providers
FFS payment is traditionally based on - ANSWER>>usual, customary, and reasonable rates (UCR)
UCR - ANSWER>>usual, customary, and reasonable rates
the part of a provider's charge that the insurance carrier allows as covered expenses
preexisting condition - ANSWER>>a physical or mental illness or disorder that existed before
the issuance of an insurance policy
2021 All Chapters
define insurance - ANSWER>>the act or business, through legal means, of protecting an
individual's person or property against loss or harm arrising out of specified circumstances in
return for payment
money recieved by insurance company in exchange for protection - ANSWER>>premium
insurance classifies "undesirable events" as - ANSWER>>illness and injury
insurance is derived from - ANSWER>>Latin word securitas, which translates to security in
English
medicare is for - ANSWER>>the elderly
medicaid is for - ANSWER>>the indigent ( those who don't not have the funds to pay for
medical treatment)
deductibles - ANSWER>>amount of covered expenses that must be incurred and paid by the
insured before benefits become payable by the insurance company
HMOs were intended to be low-cost alternatives to - ANSWER>>fee-for-service
group plans - ANSWER>>plans offered by ones employer
health insurance exchanges - ANSWER>>set of government-regulated, standardized plans
eligible for federal subsidies from which individuals can purchase low-cost health insurance
subsidies - ANSWER>>financial assistance
HIPAA - ANSWER>>health insurance portability and accountability act
HIPAA regulation for employer-sponsered group health insurance plans - ANSWER>>required to
accept transfers from other group plans without imposing a preexisting condition clause
2 common state programs for the uninsured - ANSWER>>medicaid and CHIP
, CHIP - ANSWER>>childrens health insurance program
provides care for qualifying children who are ineligble for medicaid but cannot afford private
insurance
graying of america - ANSWER>>life expectancy has increased significantly over the years
healthcare costs rise because elderly typically require more medical care
cost-sharing - ANSWER>>insured individuals pay a portion of the healthcare costs (e.g.
deductibles, coinsurance, copayment)
most covered workers require___ before plan benefits are provided. individuals must pay ___ -
ANSWER>>deductible
copayment or precent of coinsurance per encounter
indemnity plan is also refered to as - ANSWER>>fee-for-service
indemnity plan - ANSWER>>patients can choose any provider or hospital
with indemnity plan, bills are sent - ANSWER>>to the insurance carrier and the patient is
reimbursed according to the rules of the policy
managed healthcare - ANSWER>>plan attempts to control or coordinate use of health services
by its enrolled
patients see designated providers
FFS payment is traditionally based on - ANSWER>>usual, customary, and reasonable rates (UCR)
UCR - ANSWER>>usual, customary, and reasonable rates
the part of a provider's charge that the insurance carrier allows as covered expenses
preexisting condition - ANSWER>>a physical or mental illness or disorder that existed before
the issuance of an insurance policy
