Which of the following statements is correct concerning relationship between Medicare and Hmos?
Which of the following statements is CORRECT concerning the relationship between Medicare and HMOS? HMOS may pay for services not covered by Medicare. In reference to the standard Medicare Supplement benefits plans, what does the term standard mean?
What is a HMO plan quizlet?
STUDY. Managed Health Care Plan. A group of medical providers contracts with a group to provide medical care for its members at prices both agree to and are lower than the traditional cost of insurance.
Which type of Medicare policy requires insureds to use specific healthcare providers and hospitals network providers except in emergency situations?
C. Medicare SELECT *Medicare SELECT policies require insured to use specific healthcare providers and hospitals, except in emergency situations. In return, the insured pays lower premium amounts.
Which of the following is not true about Medicare quizlet?
Which of the following is not true about Medicare? Medicare is not the program that provides benefits for low income people _ that is Medicaid. The correct answer is: It provides coverage for people with limited incomes.
What are the main characteristics of an HMO quizlet?
An HMO features managed care, prepaid services, co-pays, a gatekeeper primary care physician, a limited choice of providers, and a limited service area.
What are the main characteristics of HMO?
Health Maintenance Organizations (HMOs) In a very general sense, HMOs offer predictable cost-sharing and administrative simplicity for patients. These features come with fairly restrictive rules about which providers patients may see.
What is the difference between the Medicare approved amount for service or supply and the actual charge?
BILLED CHARGE The amount of money a physician or supplier charges for a specific medical service or supply. Since Medicare and insurance companies usually negotiate lower rates for members, the actual charge is often greater than the "approved amount" that you and Medicare actually pay.
Which of the following is true concerning the conversion of group life insurance coverage to an individual policy?
The correct answer is: Evidence of insurability is required for conversion. All of the following are true regarding the conversion option for group life insurance, EXCEPT: The converted coverage must be whole life. The correct answer is: The converted coverage may be term or whole life.
Which provision concerns the insureds duty to provide the insurer with reasonable notice in the event of a loss?
Revocable. Which provision concerns the insured's duty to provide the insurer with reasonable notice in the event of a loss? Notice of claim.
Which statement is true about a member of a Medicare Advantage MA plan who wants to enroll in a Medicare supplement insurance plan?
Which statement is true about members of a Medicare Advantage (MA) Plan who want to enroll in a Medicare Supplement Insurance Plan? The consumer must be in a valid MA election or disenrollment period.
Which of the following statements best describes the relationship today between government and the economy in the United States?
Which of the following statements best describes the relationship today between government and the economy in the United States? The government has an important role in regulating and maintaining the U.S. economy.
Which of the following is not covered with Medicare Part A quizlet?
Medicare Part A covers 80% of the cost of durable medical equipment such as wheelchairs and hospital beds. The following are specifically excluded: private duty nursing, non-medical services, intermediate care, custodial care, and the first three pints of blood.