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| A self-funded provider is an employer paying claims from the employer's own funds. (T or F) |
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| Which type of provider is considered a prepaid plan? ____ ____, _____ ____ |
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| The community around the location of an HMO is referred as the ____ ____ |
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| Health Maintenance Organizations emphasize preventive medicine, including inpatient lab and x-rays however with a very high stop-loss limit. (T or F) |
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| An injury outside the service area requires the insured to obtain help at the ____ medical facility for necessary treatment. |
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| Each out-patient visit requires the insured to pay a small ______. |
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| An HMO without added optional coverages will not coer prescription drugs. (T or F) |
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| If an enrollee in a Preferred Provider Organization should utilize a provider other than a preferred provider, the (PPO) benefits are unchanged. (T or F) |
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| What combination of coverage best describes a Point of Service (POS) plan? |
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| What is the name of the military health-care plan that replaces CHAMPUS? |
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| What is the name of the physician who monitors an HMO subscriber's health care needs, and also makes referrals to specialist? A) Inn Keeper B) Tri-Care Monitor C) Gatekeeper D) Health Care |
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| An insured who utilizes a physician other than the plans primary physician can expect what percentage of the health care received to be paid by his/her HMO? A) 60% B) 80% C) 100% D) 0% |
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