Question

multiple choice question

which type of health plan combines coverage of medical costs and delivery of healthcare for a prepaid premium to providers?

• indemnity plan
• health maintenance organization
• consumer-driven health plan
• fee-for-service plan

Explanation:

Analyze the core question

The question asks to identify the type of health plan that combines the coverage of medical costs and the delivery of healthcare services for a prepaid premium paid to providers.

Evaluate the options using mastered concepts

• Indemnity plan: This is a traditional Fee-for-Service plan where the insurer pays for services after they are rendered, without integrating the actual delivery network of healthcare providers.
• Health maintenance organization (HMO): This is a prominent type of Managed Care Plans. An HMO provides comprehensive healthcare services to its members through a network of designated providers. It is funded by prepaid, fixed periodic premiums (capitation), thereby combining both the financing (coverage of medical costs) and the delivery of healthcare.
• Consumer-driven health plan (CDHP): This plan combines a high-deductible health plan (HDHP) with a tax-preferred savings account (like an HSA) to cover out-of-pocket medical expenses. It does not directly integrate prepaid delivery networks.
• Fee-for-service plan: This model pays providers based on individual services rendered rather than a prepaid, integrated premium structure.

Match definition to the correct concept

The combination of healthcare delivery and financing via prepaid premiums is the defining characteristic of a Health Maintenance Organization (HMO).

Answer:

• Indemnity plan
• Health maintenance organization (Correct answer)
• Consumer-driven health plan
• Fee-for-service plan