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Health Insurance Models and Coverage Structures Quiz

#1

What does an HMO (Health Maintenance Organization) emphasize?

Preventive care and coordination of healthcare services.
Explanation

Focus on prevention and coordinated care.

#2

What is a characteristic of a health insurance copayment?

It is a fixed amount paid by the insured individual for covered services.
Explanation

Fixed amount for covered services.

#3

Which of the following statements best describes a health insurance premium?

It is the amount an insured individual pays to the insurance company in exchange for coverage.
Explanation

Payment for coverage to the insurance company.

#4

What is the purpose of Medicaid?

To provide health insurance coverage for low-income individuals and families.
Explanation

Coverage for low-income individuals and families.

#5

Which of the following is a characteristic of a Health Maintenance Organization (HMO)?

Coverage is limited to a network of healthcare providers.
Explanation

Coverage limited to provider network in HMOs.

#6

Which of the following best describes the fee-for-service model in health insurance?

Healthcare providers are paid based on the number and type of services provided to patients.
Explanation

Providers compensated per service.

#7

In a PPO (Preferred Provider Organization), what is a key feature regarding provider choice?

Insured individuals have more flexibility in choosing healthcare providers, including specialists, within or outside the network.
Explanation

Greater provider choice for insured individuals.

#8

What is a characteristic of a high-deductible health plan (HDHP)?

Lower premiums but higher deductibles compared to traditional health plans.
Explanation

Lower premiums, higher deductibles.

#9

What is the main purpose of a health insurance deductible?

To establish the initial amount an insured individual must pay before the insurance company starts covering expenses.
Explanation

Initial amount before coverage begins.

#10

Which of the following is an advantage of a Health Savings Account (HSA)?

Unused funds can roll over from year to year and earn interest tax-free.
Explanation

Roll-over of unused funds with tax-free interest.

#11

Which of the following is true regarding Medicare Part D?

It provides coverage for prescription drugs.
Explanation

Coverage for prescription drugs under Medicare.

#12

What is the purpose of Medicare Part C, also known as Medicare Advantage?

To offer an alternative way to receive Medicare benefits through private health insurance plans.
Explanation

Alternative Medicare benefits through private plans.

#13

What is a Health Reimbursement Arrangement (HRA)?

A type of health insurance plan where the employer reimburses employees for premiums paid for individual health insurance coverage.
Explanation

Employer reimbursement for individual coverage.

#14

Which of the following is typically covered by Medicare Part A?

Skilled nursing facility care
Explanation

Coverage for skilled nursing facility care under Medicare Part A.

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