Question

practice quiz 10 - 4
page 439

1. what are the seven sources of private health plans?
2. match the following terms with the appropriate statement.

terms:

• blue cross
• blue shield
• hmos
• ppos
• point - of - service (pos) plan
• medicare
• medicaid

statements:
a. a medical assistance program offered to certain low - income individuals and families
b. a health insurance plan that combines features of both hmos and ppos
c. a statewide organization that provides hospital care benefits
d. a federally funded health insurance program available mainly to people over 65 and to people with disabilities.
e. health insurance plans that directly employ or contract with selected physicians to provide health services in exchange for a fixed, prepaid monthly premium
f. a statewide organization that provides benefits for surgical and medical services performed by physicians
g. groups of doctors and hospitals that agree to provide specified medical services to members at prearranged fees to

1. what health care services are not covered by medicare?

action activity: talk to several people covered by medicare and medicaid to obtain information on the coverage provided and the difficulties sometimes faced.

Explanation:

• Blue Cross: c. A statewide organization that provides hospital care benefits.
• Blue Shield: f. A statewide organization that provides benefits for surgical and medical services performed by physicians.
• HMOs: e. Health insurance plans that directly employ or contract with selected physicians to provide health services in exchange for a fixed, prepaid monthly premium.
• PPOs: g. Groups of doctors and hospitals that agree to provide specified medical services to members at prearranged fees.
• Point - of - service (POS) plan: b. A health insurance plan that combines features of both HMOs and PPOs.
• Medicare: d. A federally funded health insurance program available mainly to people over 65 and to people with disabilities.
• Medicaid: a. A medical assistance program offered to certain low - income individuals and families.

Answer:

Blue Cross - c, Blue Shield - f, HMOs - e, PPOs - g, POS plan - b, Medicare - d, Medicaid - a