Health Insurance Challenges for Employed and Unemployed Individuals
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Questions and Answers

Which factor contributes the least to premature death?

  • Medical Care (correct)
  • Lifestyle and Behaviors
  • Social and Environmental Factors
  • Genetic

During the 1950s, where were health services primarily provided?

  • Outpatient centers
  • Hospitals
  • Doctor's offices
  • Patient's homes (correct)

What is the most prevalent mode of paying for health care?

  • Individual Private Insurance
  • Employment-Based Private Insurance (correct)
  • Government Financing and Subsidies
  • Out of Pocket

Which insurance plan covers hospital care and gives the choice of hospitals?

<p>Blue Cross (A)</p> Signup and view all the answers

Which insurance plan covers physician and other outpatient services?

<p>Blue Shield (A)</p> Signup and view all the answers

Which part of Medicare provides hospital insurance?

<p>Medicare Part A (A)</p> Signup and view all the answers

Which part of Medicare provides prescription drug coverage through private health plans?

<p>Medicare Part D (B)</p> Signup and view all the answers

Which group is more likely to be uninsured based on the information provided?

<p>Unemployed individuals with low income (C)</p> Signup and view all the answers

What is one of the reasons why the 'Employed Uninsured' group may not have health insurance?

<p>They work for small firms that don't offer health insurance (B)</p> Signup and view all the answers

Which form of financing for health insurance is regressive based on the information provided?

<p>Financing that takes a falling percentage of income as income increases (A)</p> Signup and view all the answers

What type of health insurance coverage requires a primary care physician (PCP) responsible for healthcare, referrals to specialists, and approving medical treatment?

<p>HMO (D)</p> Signup and view all the answers

Which type of health insurance coverage allows enrollees to self-refer to another physician and has a wide choice of providers and hospitals?

<p>PPO (B)</p> Signup and view all the answers

What type of health insurance coverage requires a PCP and combines fee-for-service and pre-paid insurance?

<p>POS (C)</p> Signup and view all the answers

What is the purpose of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)?

<p>To guarantee insurance at group insurance rates for 18 months (A)</p> Signup and view all the answers

Which payment model combines elements of capitation and fee for service?

<p>Risk Adjusted Capitation (B)</p> Signup and view all the answers

Which payment model involves an established rate to cover a person's medical care for a specified time?

<p>Capitation (C)</p> Signup and view all the answers

Which payment model involves a bundled payment for a case or episode of illness?

<p>Episode of Illness (C)</p> Signup and view all the answers

Which payment model is based on estimating time, mental effort, judgement, skill, physical effort, and stress?

<p>Medicare Resource Based Relative Value Scale (C)</p> Signup and view all the answers

What is the financing source for Medicare Part A?

<p>Social security taxes collected from employers and employees (A)</p> Signup and view all the answers

Who is eligible for Medicare Part B?

<p>Anyone (D)</p> Signup and view all the answers

What is the financing source for Medicare Part C?

<p>Federal Revenues (B)</p> Signup and view all the answers

What is the financing source for Medicare Part D?

<p>73% Federal Revenue (B)</p> Signup and view all the answers

What is the financing source for Medicaid?

<p>State and Federal taxes (B)</p> Signup and view all the answers

What is the financing source for SCHIP?

<p>State and Federal taxes (C)</p> Signup and view all the answers

Which factor contributes the most to premature death?

<p>Lifestyle and Behaviors (A)</p> Signup and view all the answers

In the 1950s, where were health services primarily provided?

<p>Patient's homes (C)</p> Signup and view all the answers

What is the most prevalent mode of paying for health care?

<p>Employment-Based Private Insurance (A)</p> Signup and view all the answers

Which type of health insurance coverage allows enrollees to self-refer to another physician and has a wide choice of providers and hospitals?

<p>Preferred Provider Organization (PPO) (D)</p> Signup and view all the answers

Which part of Medicare provides prescription drug coverage through private health plans?

<p>Medicare Part D (D)</p> Signup and view all the answers

Which form of financing for health insurance is regressive based on the information provided?

<p>Out of Pocket (A)</p> Signup and view all the answers

Which group is more likely to be uninsured based on the information provided?

<p>Unemployed Uninsured (C)</p> Signup and view all the answers

What is one of the reasons why the 'Employed Uninsured' group may not have health insurance?

<p>All of the above (D)</p> Signup and view all the answers

Which payment model combines elements of capitation and fee-for-service?

<p>IBRA (C)</p> Signup and view all the answers

What type of health insurance coverage requires a primary care physician (PCP) responsible for healthcare, referrals to specialists, and approving medical treatment?

<p>Health insurance with a PCP (C)</p> Signup and view all the answers

Which part of Medicare provides prescription drug coverage through private health plans?

<p>Part D (A)</p> Signup and view all the answers

What is the purpose of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)?

<p>To provide continuation of health coverage after job loss (C)</p> Signup and view all the answers

Which payment model attempts to correct for bias in physician payments and takes into consideration factors such as time, mental effort, judgement, and skill?

<p>Medicare Resource Based Relative Value Scale (A)</p> Signup and view all the answers

Which payment model involves an established rate to cover a person's medical care for a specified time, with adjustments made for financial risk?

<p>Capitation (D)</p> Signup and view all the answers

Which payment model involves a bundled payment for a case or episode of illness, with the provider being at risk if they pay more for the services provided than the total bundle amount?

<p>Episode of Illness (C)</p> Signup and view all the answers

Which payment model allows physicians to set the price and the insurance provider pays, but created a moral hazard due to the lack of cost-sharing?

<p>Fee For Service (C)</p> Signup and view all the answers

Which payment model involves an intermediary group that pays physicians a salary and bears the financial risk for diagnostic and specialty services?

<p>Three Tiered Payment Model (B)</p> Signup and view all the answers

Which payment model involves physicians being paid a salary based on time, and is most evident in the public sector?

<p>Physician Payment by Time (B)</p> Signup and view all the answers

What is the most popular type of health insurance coverage in the 1900s?

<p>Indemnity (B)</p> Signup and view all the answers

What type of health insurance coverage requires a PCP responsible for healthcare and making referrals to specialists?

<p>HMO (B)</p> Signup and view all the answers

What is the main advantage of Preferred Provider Organization (PPO) health insurance coverage?

<p>Wide choice of providers and hospitals (C)</p> Signup and view all the answers

What is the main disadvantage of Point of Service (POS) health insurance coverage?

<p>Difficulty obtaining specialized care referrals (C)</p> Signup and view all the answers

What is the purpose of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)?

<p>To provide insurance at group insurance rates for 18 months for people who lose insurance (C)</p> Signup and view all the answers

What model of health care emphasizes the well-being of all aspects of a person's life, including the spiritual dimension?

<p>Holistic Model (C)</p> Signup and view all the answers

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