Chapter 6: Financing Health Care and Reimbursement

Question 1

Durable medical equipment (DME)

Answer 1

Medical equipment prescribed for the subscriber

Question 2

Premium
Deductible
Co-payments
Coinsurance

Answer 2

Premium: cost of the policy
Deductible: amount subscriber pays before health insurer pays
Co-payments: flat amount subscriber pays for each visit for service
Coinsurance: percent that subscriber pays for services (usually 20%)

Question 3

Medicare Part A

Answer 3

covers inpatient hospital care; voluntary, requires premium and deductible

Question 4

Medicare Part B

Answer 4

covers outpatient care and medical equipment

Question 5

Medicare Part D

Answer 5

subsidizes cost of drugs

Question 6

Managed Care Organizations

Answer 6

Restrict access to services by limiting the types of, number of, or payment for services covered
Ie. Health maintenance organizations (HMOs), Preferred provider organization (PPO), and Point of Service (POS)