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</p> Signup and view all the answers

    Which insurance plan covers physician and other outpatient services?

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

    Which part of Medicare provides hospital insurance?

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

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

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

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

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

    Who is eligible for Medicare Part B?

    <p>Anyone</p> Signup and view all the answers

    What is the financing source for Medicare Part C?

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

    What is the financing source for Medicare Part D?

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

    What is the financing source for Medicaid?

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

    What is the financing source for SCHIP?

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

    Which factor contributes the most to premature death?

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

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

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

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

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

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

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

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

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

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

    <p>IBRA</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</p> Signup and view all the answers

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

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

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

    <p>Indemnity</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</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</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</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</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</p> Signup and view all the answers

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