ATI Fundamentals Study Guide

Medicare Correct Answer - for clients over age 65 and/or with permanent disabilities. premiums applied as insurance program reimburses providers based on DRGs. Premiums applied as Managed Care Organizations (MCOs) provide enrolled clients with comprehensive care overseen by a primary care provider. Is federally funded. Medicaid Correct Answer - for clients with low income. is federally funded and individual states determine eligibility requirements. Traditional Insurance Correct Answer - reimburses for services on fee-for-service basis. Managed Care Organizations (MCOs) Correct Answer - comprehensive care is overseen by a primary care provider & focuses on prevention and health promotion Preferred Provider Organizations (PPOs) Correct Answer - client chooses from a list of contracted providers. using non-contracted providers increases the client's out of pocket costs Exclusive Provider Organizations (EPOs) Correct Answer - the client chooses from a list of providers within a contracted organization Long-Term Care Insurance Correct Answer - provides for long-term care expenses not covered by Medicare Preventive health care Correct Answer - focuses on educating and equipping clients to reduce and control risk factors of disease. Examples include immunizations, stress management programs, and seat belt use