GBA 1 ASSIGNMENT 3 QUESTIONS AND ANSWERS
prepaid service plans - CORRECT ANSWER✅✅✅this type of plan provided a set allowance (level of
benefit) for hospital/medical services and paid them directly to the provider
ex: blue cross blue shield
indemnity plans - CORRECT ANSWER✅✅✅plans that reimbursed or indemnified a set dollar amount
to the subscriber
first dollar coverage - CORRECT ANSWER✅✅✅plan pays benefits from the minute an expense is
incurred. the subscriber pays no expense. this model was used in early hospital and medical plans when
costs and utilization patterns were lower
this type of coverage is not used often today
it has been replaced with plans that use deductibles, coinsurance provisions or other cost containment
measures. managed care has also replaced this type of coverage
list the types of hospitalization benefits covered in health plans - CORRECT ANSWER✅✅✅1.
inpatient room and board
2 emergency care
3 intensive and specialty care
4 maternity and newborn care
5 xray, diagnostic testing and laboratory expenses in a hospital
6 skilled nursing facility care
7 radiation and chemo
8 inpatient mental and nervous care
9 inpatient drup and alcohol abuse care
10 physical, inhalation andcardiac therapy
, 11 home health care
12 hospice
13 respite care
list the types of medical benefits covered in health plans - CORRECT ANSWER✅✅✅1. surgeons
2 anesthesiologists
3 nurse and other surgical assistants
4 service fees assoc with inpatient medical care
5 second surgical opinions
6 xray and diagnostic and lab expenses
7 skilled nursing care
8 obs and pediatriacians assoc with prenatal delivery and newborn care
9 inpatient ICU
10 allergy testing
11 transplant services
12 administration of radiation and chemotherapy
13 inpatient physical therapy
14 immunizations for children
what were the early cost sharing techniques used in major medical coverage? - CORRECT
ANSWER✅✅✅deductibles and coinsurance
deductibles - CORRECT ANSWER✅✅✅the amount of covered medical expense that a subscriber
must pay before the plan pays benefits
coinsurance - CORRECT ANSWER✅✅✅amount that is usually a percentage of total charges for which
the plan participant is responsible once the deductible is exceeded
what are the good parts to using deductibles and coinsurance as cost saving devices? - CORRECT
ANSWER✅✅✅1. may lead to a reduction in the use of health services and thus a reduction in costs
prepaid service plans - CORRECT ANSWER✅✅✅this type of plan provided a set allowance (level of
benefit) for hospital/medical services and paid them directly to the provider
ex: blue cross blue shield
indemnity plans - CORRECT ANSWER✅✅✅plans that reimbursed or indemnified a set dollar amount
to the subscriber
first dollar coverage - CORRECT ANSWER✅✅✅plan pays benefits from the minute an expense is
incurred. the subscriber pays no expense. this model was used in early hospital and medical plans when
costs and utilization patterns were lower
this type of coverage is not used often today
it has been replaced with plans that use deductibles, coinsurance provisions or other cost containment
measures. managed care has also replaced this type of coverage
list the types of hospitalization benefits covered in health plans - CORRECT ANSWER✅✅✅1.
inpatient room and board
2 emergency care
3 intensive and specialty care
4 maternity and newborn care
5 xray, diagnostic testing and laboratory expenses in a hospital
6 skilled nursing facility care
7 radiation and chemo
8 inpatient mental and nervous care
9 inpatient drup and alcohol abuse care
10 physical, inhalation andcardiac therapy
, 11 home health care
12 hospice
13 respite care
list the types of medical benefits covered in health plans - CORRECT ANSWER✅✅✅1. surgeons
2 anesthesiologists
3 nurse and other surgical assistants
4 service fees assoc with inpatient medical care
5 second surgical opinions
6 xray and diagnostic and lab expenses
7 skilled nursing care
8 obs and pediatriacians assoc with prenatal delivery and newborn care
9 inpatient ICU
10 allergy testing
11 transplant services
12 administration of radiation and chemotherapy
13 inpatient physical therapy
14 immunizations for children
what were the early cost sharing techniques used in major medical coverage? - CORRECT
ANSWER✅✅✅deductibles and coinsurance
deductibles - CORRECT ANSWER✅✅✅the amount of covered medical expense that a subscriber
must pay before the plan pays benefits
coinsurance - CORRECT ANSWER✅✅✅amount that is usually a percentage of total charges for which
the plan participant is responsible once the deductible is exceeded
what are the good parts to using deductibles and coinsurance as cost saving devices? - CORRECT
ANSWER✅✅✅1. may lead to a reduction in the use of health services and thus a reduction in costs
