Which of he following stalements is CORRECT about benefits provided by a Basic Hospital and Surgical policy?
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Which of he following stalements is CORRECT about benefits provided by a Basic Hospital and Surgical policy?
A.They are lower than he actual expenses incurred
B.They are subject to large deductibles
C.They are higher than those provided by Major Medical policies
D.They are unlimited.
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- Which of he following stalements BEST describes the primary difference between a Health Maintenance Organizalion (HMO) and a Preferred Provider Organization (PPO)? A.Under a PPO lhe insured may use any medical provider whereas providers are restricted with HMOs. B.Under an tvo the deductibles are higher than are those of PPOs. C.POs do not provide preventive care benefits whereas HMOs do D.HMOs utilize larger cost sharing than do PPOsThe fact that most medical care purchases are financed through insurance: has no effect on health care consumption because aggregate costs are the same regardless of payment method. reduces the amount of health care consumed. has decreased health care costs and therefore reduced aggregate health care expenditures. increases the amount of health care consumed.Which is Idemenity Plan and which is Managed Care Plan? Insureds create contract with an insurer who does not provide health care services The higher the deductible, the lower the premium Insured receive health care services from a designated group of providers May not even involve an insurance company No annual deduction is incurred, but a small co-payment may be required I most value the freedom of choice and am willing to pay for it. Cost is my most important consideration. I’d rather have the flexibility of either having the insurance company reimburse me or directly paying the health care provider.
- How can a patient benefit if the premiums paid are more than the cost of the medical care received? How can an insurance company benefit if the medical care it provides costs more than the premiums paid in?In the context of the health insurance and the life insurance, choose the sentence that IS NOT CORRECT: * The deductible in a health insurance is an amount of money the insured must pay before benefits become payable by the insurance company. When we buy a health insurance, we should make sure that we have enough insurance (the opportunity cost of not being adequately insured can be extremely high), but without wasting money by overinsuring Group Health Insurance (most of them being employer sponsored) represents a small percentage (around 5%) of all health insurance issued by health and life insurance companies. In a life insurance, a person purchases a policy by paying a premium and the insurance company promises to pay a sum of money at the time of the policyholder’s death to the designated beneficiary.The following information has been gathered onthe costs and effectiveness of the two treatments, Aand B. In this problem, costs and consequences arenot discounted.a. What is the total cost for the survivors receivingtreatment A? For decedents (assuming suddendeath)?b. What is the total cost for survivors receivingtreatment B? For decedents?c. What is the expected cost for those patientsreceiving treatment A? And treatment B?d. Draw a simple decision tree showing the costsand consequences of each treatment option.e. Calculate the incremental cost and incrementalbenefit of the treatment alternatives.f. What is the ICER?
- By increasing demand, health insurance creates a. A deadweight loss related to overconsumption. b. A deadweight loss related to underconsumption. c. Neither of the above.Which of the following statements is true regarding postretirement health care benefit obligations and their accounting? a. The estimates involved in accounting for such benefits are generally less complex than those associated with accounting for pensions. b. Such benefits are usually provided as part of a defined contribution postretirement benefits plan. c. Employers usually offer multiple varying tiers of coverage based on beneficiaries’ length of service with the company. d. The gross cost of providing such coverage is commonly offset by government-provided health insurance.8. What is the difference between a copay and coinsurance? a. Copay is typically a percentage of the health care service, coinsurance is a flat fee b. Copay is typically a flat fee, coinsurance is a percentage of the health care service c. Copay is paid by the individual when receiving a health care service, coinsurance is paid by the insurance company
- An important distinction in health insurance is between the list price (PL) and out-of-pocket price (PP) of a medical good or service. The list price is the official price that the provider charges the insurance company, while the out-of-pocket price is the price that the insurance customer faces. Sometimes, the out-of-pocket price depends on the list price. Now assume the consumer is part of a partial insurance plan with a coinsurance provision. Her insurance pays 50% of all medical expenses. Consider again the relationship between PL and PP and plot a coinsurance plan demand curve in PL - Q space. Label this curve D3. Finally, assume the consumer is part of a partial insurance plan with a copayment provision. Her insurance pays all expenses above and beyond her copayment of $25 for each unit of Q. Consider again the relationship between PL and PP and plot a copayment-plan demand curve in PL - Q space. Label this curve D4.Traditional indemnity policies reimburse the insured based on the [amount charged | usual, customary, and reasonable (UCR) charges] for the medical services received. a. amount charged b. usual, customary, and resonable (UCR) chargesHow does the imperfect information in insurance markets cause an increase in health care costs? Explain with great detail.