HMO

Question

a. A federal program that provides health insurance primarily for those age 65 and older and persons with chronic disabilities, Amyotrophic Lateral Sclerosis, or end-stage renal disease under the age of 65
b. Also known as traditional, commercial insurance or fee-for-service plans; a type of health insurance that places no restrictions on which doctors may be used; referrals are not required and most pay a percentage of medical expenses based on a UCR, after an annual deductible is paid by the patient
c. Physicians and facilities, such as hospitals, who have agreed to provide services to patients on a discounted fee schedule
d. A federal/state entitlement program that provides medical assistance for families and individuals with low incomes and limited resources
e. New health plan products that give medical consumers more choices and control over spending by having access to funds reserved for health care
f. A type of managed care plan that requires patients to have a gatekeeper, or PCP, in order for health care services to be coordinated and costs to be better controlled
g. A type of managed care plan that includes an in-network and out-of network component allowing patients to choose how benefits will be used.
Broader coverage and less out-of-pocket expense is realized when using services with in-network providers.

Answer 1

f. A type of managed care plan that requires patients to have a gatekeeper, or PCP, in order for health care services to be coordinated and costs to be better controlled