A client is a member of a group insurance plan in which he pays a preset, fixed fee for healthcare services. What type of insurance plan does the nurse understand the client to have?
A) A preferred provider organization (PPO)
B) A health maintenance organization (HMO)
C) Medicare
D) Medicaid
B
Feedback:
An HMO is a group insurance plan in which participants pay a preset, fixed fee in exchange for healthcare services. The fee is not based on the number of services provided but rather is projected to the number of participants and expected services. A PPO operates on the principle that competition can control costs. Acting as agents for health insurance companies, PPOs create a community network of providers who are willing to discount their fees for service in exchange for a steady stream of referred customers. Medicare is for people that are age 65 years and older or disabled. Medicaid is coverage for those clients who are unable to afford healthcare.
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