Wisconsin Accident and Health Insurance Exam 2 Questions and Answers 2024

Wisconsin Accident and Health Insurance Exam 2 Questions and Answers 2024 Alan is an enrollee of a health maintenance organization (HMO) which uses a gatekeeper system. If there ever comes a time when he needs emergency health services, what should he do? Receive permission from the primary physician to begin treatment. Call the HMO to verify coverage. Proceed to the nearest emergency room. Contact the HMO for a listing of approved providers. - CORRECT ANSWER-Proceed to the nearest emergency room. What is a major difference between private commercial insurers and HMO's? An HMO pays claims on a fee-for-service basis. A private commercial insurer typically has fewer health provider choices. An HMO combines medical care delivery and funding in one organization. A private commercial insurer only offers individual coverage. - CORRECT ANSWER-An HMO combines medical care delivery and funding in one organization Which of the following health plans pay benefits on a pre-paid service basis? Medicare. Medicaid. Group medical expense. HMO. - CORRECT ANSWER-HMO In a staff model HMO, enrollees normally have which of the following pharmacy options available to them? Mail-order pharmacy. In-house pharmacy. Captive pharmacy. Network pharmacies. - CORRECT ANSWER-In-house pharmacy. Inpatient psychiatric care is covered under Part A Medicare for 190 days per Admission. Year. Benefit period.