#1
Which health insurance model is characterized by a network of healthcare providers who agree to provide services at a reduced cost?
Fee-for-service
Health Maintenance Organization (HMO)
Preferred Provider Organization (PPO)
Exclusive Provider Organization (EPO)
#2
What is the primary purpose of a Health Savings Account (HSA) in the context of health insurance?
To provide coverage for catastrophic medical expenses
To accumulate tax-free funds for medical expenses
To offer supplemental insurance coverage
To manage prescription drug costs
#3
What is the primary purpose of a Preferred Provider Organization (PPO) in health insurance?
To provide comprehensive coverage with no restrictions
To offer exclusive access to a specific network of providers
To encourage preventive care services
To negotiate discounted rates with a network of healthcare providers
#4
What is the primary purpose of a Catastrophic Health Insurance Plan?
To provide coverage for routine preventive care
To offer comprehensive coverage for major medical expenses
To protect against high out-of-pocket costs in case of a serious illness or injury
To cover elective cosmetic procedures
#5
What is the primary purpose of the Affordable Care Act (ACA) in the United States?
To establish a nationalized healthcare system
To provide subsidies for cosmetic surgeries
To expand access to health insurance coverage and improve healthcare quality
To limit the availability of preventive care services
#6
In a Health Maintenance Organization (HMO), how are healthcare services typically arranged?
On a fee-for-service basis
Through a network of preferred providers
With no restrictions or referrals required
Exclusively through private practitioners
#7
What is the key characteristic of a Point of Service (POS) health insurance plan?
Requires a primary care physician referral for specialists
No restrictions on choosing healthcare providers
Strictly fee-for-service model
Only covers preventive care services
#8
Which federal program provides health insurance coverage for individuals aged 65 and older?
Medicaid
CHIP (Children's Health Insurance Program)
Medicare
Affordable Care Act (ACA)
#9
In the context of health insurance, what is the purpose of 'utilization management'?
Evaluating the effectiveness of insurance plans
Managing the use of healthcare resources to control costs
Determining eligibility for insurance coverage
Negotiating contracts with healthcare providers
#10
In the context of health insurance, what does the term 'co-insurance' refer to?
A fixed amount paid for covered services
A percentage of covered expenses paid by the insured
Additional coverage for specific medical conditions
A waiting period before coverage begins
#11
Which provider structure involves a group of healthcare providers who share facilities and equipment, collaborating to deliver comprehensive care?
Integrated delivery network (IDN)
Accountable Care Organization (ACO)
Managed care organization (MCO)
Physician-Hospital Organization (PHO)
#12
In the context of health insurance, what does the term 'capitation' refer to?
A fixed fee per insured person, regardless of services rendered
An annual maximum limit on coverage
A type of co-payment for prescription drugs
A percentage of the total healthcare costs covered by the insured
#13
What is a common characteristic of High Deductible Health Plans (HDHPs)?
Low monthly premiums
Comprehensive coverage with low deductibles
Limited coverage for preventive care
Exclusively available through employer-sponsored plans
#14
What role does a Health Reimbursement Arrangement (HRA) play in health insurance?
It is a type of insurance policy
It provides tax-free funds for qualified medical expenses
It manages the utilization of healthcare services
It offers catastrophic coverage for serious illnesses
#15
What is the main objective of Managed Care Organizations (MCOs) in health insurance?
To maximize out-of-pocket expenses for insured individuals
To provide unlimited access to healthcare services
To control and coordinate healthcare services to reduce costs
To exclude preventive care from coverage