CPCU 553 Ch. 11 Flashcards Preview

CPCU 553 > CPCU 553 Ch. 11 > Flashcards

Flashcards in CPCU 553 Ch. 11 Deck (11)
Loading flashcards...
1
Q

A type of healthcare plan that allows patients to choose their own healthcare provider and reimburses the patient or provider as a certain percentage (usually after a deductible is paid) for services provided

A

Indemnity plan

2
Q

Coverage for medical expenses, such as hospital and surgical expenses, physicians visits, and miscellaneous medical services

A

Basic medical expense coverage

3
Q

Insurance that covers medical expenses resulting from illness or injury that are not covered by a basic medical expense plan

A

Major medical insurance

4
Q

A type of healthcare plan that provides members with comprehensive services and encourages them to use providers belonging to the plan

A

Managed care plans

5
Q

An organization that provides all the care needed by its members in exchange for a fixed fee

A

Health maintenance organization (HMO)

6
Q

An administrative organization that meets the common needs of healthcare providers and clients that identify networks or providers and contracts for their medical services at discounted rates

A

Preferred provider organization (PPO)

7
Q

Managed care plan that combines the characteristics of an HMO and a PPO; has a network of preferred providers who, if used by the members, charge little or nothing for services; healthcare received out of the network covered, but members must pay substantially higher coinsurance charges and a deductible

A

Point of service (POS) plan

8
Q

Social insurance program that covers the medical expenses of most individuals age sixty five or older

A

Medicare

9
Q

Health insurance plan options that provide benefits in addition to basic medicare; offered by private insurers that contract with medicare and available to beneficiaries currently enrolled in Medicare Part A and Part B

A

Medicare advantage plan

10
Q

Medical insurance provision that requires the insured to pay part of that covered medical expenses in excess of the deductible Coinsurance

A

Coinsurance

11
Q

Initial time period in a health insurance or disability income policy during which benefits are not paid

A

Eliminated period