Deck 2: Paying for Healthcare

Question 1

What is the source of funding for the TRICARE For Life program?

A) beneficiary-paid premiums
B) the Veterans Administration
C) Medicare
D) tariffs on imported products

Answer 1

Medicare

Question 2

In 2010, healthcare costs accounted for approximately what percentage of the gross domestic product of the U. S. A.?

A) 8%
B) 13%
C) 18%
D) 23%

Answer 2

18%

Question 3

What type of healthcare insurance coverage is most common in America?

A) private insurance from employer
B) private insurance individually purchased
C) government insurance (all combined)
D) no insurance

Answer 3

private insurance from employer

Question 4

Individuals covered by a high deductible health plan within a preferred provider organization use fewer outpatient services and shop around for lower cost outpatient services because they ____.

A) pay directly for routine care
B) are retirees on fixed budgets
C) get rebates for spending less on care
D) pay taxes on healthcare expenditures

Question 5

When a person insured with a preferred provider organization plan receives healthcare services from a provider who does not participate in the plan, the insured person ____.

A) gets a lower deductible
B) has a reduced copayment
C) pays more for the service
D) loses insurance coverage

Question 6

Which act allowed Medicare-eligible persons to receive Medicare benefits from private insurers?

A) Balanced Budget Act of 1997
B) Medicare Prescription Drug, Improvement, and Modernization Act of 2003
C) American Recovery and Reinvestment Act of 2009
D) Social Security Act of 1935

Question 7

Usual, Customary, and Reasonable fees are ____.

A) set by hospital and physician organizations
B) based on surveys conducted by insurance companies
C) the lowest fees that healthcare providers will accept
D) based on the consumer price index

Question 8

An individual works at a business that covers half the cost of a group healthcare insurance plan with the other half paid by the employee. The individual quits his job but wishes to retain group healthcare insurance as per COBRA. How much will he pay for coverage?

A) The same amount he paid while employed
B) The same amount he paid while employed plus an administrative fee
C) Twice the amount he paid while employed
D) Twice the amount he paid while employed plus an administrative fee

Question 9

Prescription drugs for the elderly are covered under ____.

A) Medicare Part A
B) Medicare Part B
C) Medicare Part C
D) MMA (2003)

Question 10

TRICARE Insurance is a private company contracted by the federal government to provide healthcare insurance to members of the armed forces.

Question 11

Premium payments from Medicare recipients cover what portion of Medicare's prescription drug benefits?

A) 10%
B) 25%
C) 50%
D) 85%

Question 12

Preferred provider organization (PPO) plans are a form of managed care.

Question 13

The federal government's first involvement in healthcare financing was based on the Social Security Amendments of 1965.

Question 14

Rising healthcare insurance costs in a tight employment market (fewer jobs and many qualified applicants) will likely result in employers ____.

A) covering a greater portion of employee healthcare insurance costs
B) dropping part-time positions in favor of fewer full-time positions
C) eliminating healthcare insurance as a benefit
D) firing workers with the greatest healthcare expenditures

Question 15

Which of the following programs currently allows armed forces members and their eligible dependents to be reimbursed for services provided by civilian healthcare providers?

A) CHAMPUS
B) TRICARE Extra
C) TRICARE Prime
D) TRICARE Standard

Question 16

Medicare beneficiary premiums cover only one-fourth of Medicare Part B costs.

Question 17

Americans without healthcare insurance (private or government) ____.

A) cannot get care at for-profit hospitals
B) numbered around 80 million in 2009
C) typically were denied private healthcare insurance
D) pay directly for routine medical care

Question 18

Healthcare providers who participate in a capitated payment type of health maintenance organization ____.

A) pay directly for medical services
B) are salaried employees of the HMO
C) get paid a per member per month rate
D) receive bonuses for spending more time with patients.

Question 19

The Gross Domestic Product (GNP) is the total output of all the business enterprises of a country.

Question 20

Most healthcare providers receive most of their payments from ____.

A) patients
B) patients' families
C) the federal government
D) third-party payers

Question 21

The Congressional Budget Office predicted that annual Medicare expenditures will exceed one trillion dollars in the year ____________________.

Question 22

Group healthcare insurance plans were first seen in America ____.

A) in the late 1800s
B) during the Great Depression
C) shortly after World War II
D) in 1965

Question 23

Uncompensated hospital care in 2009 ____.

A) was 20% of hospital expenses
B) was 10% of hospital expenses
C) was almost $100 billion
D) was almost $40 billion

Question 24

Medicare beneficiaries in 2010 who needed expensive drugs would pay up to ____ out-of-pocket due to the "donut hole" in coverage under the MMA (2003).

A) $550
B) $1,550
C) $4,550
D) $7,550

Question 25

The two types of care covered by Medicare Part A are hospitalizations and limited stays for ____________________ in skilled nursing facilities.

Question 26

Describe preferred provider organization plans and explain their limited ability to control healthcare costs.

Question 27

In 2010, the average cost for family coverage in an employer-based group healthcare insurance plan was $_______________.

Question 28

The Social Security Act of 1935 ____.

A) was part of Truman's Fair Deal
B) provides retirement funds based on employee-paid premiums
C) included health insurance coverage
D) provides retirement funds from taxes on current workers

Question 29

A self-employed person who earns $100,000 must pay a Medicare payroll tax of $____________________.

Question 30

An employee and his wife receive healthcare insurance from the employer's group plan. On the employee's 65th birthday, he becomes eligible for Medicare and ineligible for his employer's group healthcare insurance plan. The employee's wife is 61 years old. Based on COBRA, she will be eligible for coverage under the employer's group plan for ____________________ months.

Question 31

Which type of healthcare insurance program uses primary care "gatekeepers"?

A) CHAMPUS
B) HMOs
C) PPOs
D) TRICARE Standard

Question 32

Why are hospitals most affected by large numbers of uninsured persons?

Question 33

Describe the Children's Health Insurance Program of 1997.

Question 34

A rural village has one family physician. The nearest hospital, 25 miles away, is a thirty-bed facility owned by the physicians who practice in the rural county. Explain why village residents are unlikely to use a preferred provider organization or a health maintenance organization.

Question 35

Describe the American Recovery and Reinvestment Act of 2009 (ARRA), its relation to COBRA, and how its costs are paid.