#1
Which of the following is a characteristic of a Health Maintenance Organization (HMO)?
Requires a primary care physician (PCP) referral for specialist visits
ExplanationHMOs mandate a PCP referral for specialist consultations.
#2
Preferred Provider Organizations (PPOs) typically offer:
Greater flexibility in choosing healthcare providers
ExplanationPPOs provide increased flexibility in selecting healthcare providers.
#3
Which of the following statements best describes a Health Savings Account (HSA)?
It allows individuals to save money tax-free for medical expenses
ExplanationHSAs enable tax-free savings for medical expenses.
#4
What is a common feature of a Point of Service (POS) plan?
Requires a PCP referral for specialist visits
ExplanationPOS plans necessitate a PCP referral for specialist appointments.
#5
In managed care, the term 'gatekeeper' refers to:
The primary healthcare provider who coordinates a patient's care
ExplanationThe 'gatekeeper' in managed care is the primary healthcare provider coordinating patient care.
#6
Which of the following is a key role of utilization review in managed care?
To ensure appropriate and cost-effective use of healthcare resources
ExplanationUtilization review in managed care aims to ensure appropriate and cost-effective use of healthcare resources.
#7
Which of the following is NOT a typical characteristic of an Exclusive Provider Organization (EPO)?
Provides coverage for out-of-network services
ExplanationEPOs do not typically cover out-of-network services.
#8
Which of the following statements accurately describes a Health Reimbursement Arrangement (HRA)?
It allows employees to carry over unused funds to the next year
ExplanationHRAs permit employees to carry over unused funds to the following year.
#9
What is a common feature of a Health Savings Account (HSA)?
Allows individuals to save money tax-free for medical expenses
ExplanationHSAs allow individuals to save money tax-free for medical expenses.