Question 1

All of the following are aims of the Affordable Care Act except:

Accepted Answer

The Affordable Care Act does not aim to permit insurance fraud; rather, it seeks to prevent it while expanding coverage, improving quality, and controlling costs.

Question 2

The Affordable Care Act states that health plans must offer a minimum level of benefits to qualify for inclusion in state exchanges, including all except which of the following?

Accepted Answer

Cosmetic procedures are not considered essential health benefits under the Affordable Care Act and are typically not covered by health plans in state exchanges.

Question 3

The Affordable Care Act emphasizes coverage for preventive services and a reformed delivery system that includes which of the following?

Accepted Answer

The Affordable Care Act (ACA) emphasizes a reformed delivery system that includes primary care providers, medical homes, and community-based health centers to improve access to preventive services and coordinated care.

Question 4

The new structure of the Affordable Care Act focuses on preventive care and wellness, and a client-centered approach to treating and managing various:

Accepted Answer

The Affordable Care Act emphasizes preventive care and wellness, particularly in managing chronic diseases, to improve health outcomes and reduce healthcare costs.

Question 5

Which of the following is known as the Medicare Supplemental Insurance?

Accepted Answer

Medigap is known as Medicare Supplemental Insurance, which helps cover some of the healthcare costs that Medicare does not cover, such as copayments, coinsurance, and deductibles.

Question 6

Most preferred provider organizations (PPOs) cover visits to the physician, well-baby care, immunizations, and mammograms, all of which are considered:

Accepted Answer

Preventive care refers to medical services that are aimed at preventing health problems or detecting them early, such as immunizations, well-baby care, and screenings like mammograms.

Question 7

What does TANF stand for?

Accepted Answer

TANF stands for Temporary Assistance for Needy Families, which is a federal assistance program in the United States.

Question 8

Fee-for-service plans are the traditional type of healthcare policy. The client determines a price for each type of service delivered, and then the insurance company pays the fee.

Accepted Answer

In fee-for-service plans, the healthcare provider sets the price for each service, and the insurance company reimburses the provider or the patient according to the policy terms, not the client.

Question 9

The Medicare system is based on fee-for-service for paying physicians. Medicare pays an individual physician an amount that does not exceed the 75th percentile of charges by all physicians in a community.

Accepted Answer

Medicare pays physicians based on a fee-for-service model, where they are reimbursed for each service they provide.

Question 10

A preferred provider organization is a combination of traditional fee-for-service and an HMO. Similar to an HMO, clients use the physicians and hospitals that have agreed to give discounts to their insurer.

Accepted Answer

A preferred provider organization (PPO) combines elements of traditional fee-for-service plans and Health Maintenance Organizations (HMOs) by allowing clients to use a network of preferred providers who offer services at discounted rates.

Question 11

Medicare Part A coverage is generally provided automatically and free of premiums to persons age 65 or over who are eligible for Social Security or Railroad Retirement benefits, whether they have claimed these monthly cash benefits or not.

Accepted Answer

Medicare Part A is typically premium-free for individuals 65 or older who are eligible for Social Security or Railroad Retirement benefits, regardless of whether they have claimed these benefits.

Question 12

Medicare Part D coverage provides subsidized access to prescription drug insurance coverage on a voluntary basis upon payment of a premium.

Accepted Answer

Medicare Part D is a voluntary program that offers prescription drug coverage to Medicare beneficiaries, who pay a premium for this insurance.

Question 13

The Balanced Budget Act included a state option known as Programs of All-Inclusive Care for the Elderly (PACE).

Accepted Answer

The Balanced Budget Act of 1997 included the PACE program as a state option to provide comprehensive medical and social services to certain elderly individuals.

Question 14

The main function of the Affordable Care Act is to produce private health insurance exchanges in every state. These exchanges will serve as a marketplace for consumers, offering local, standardized healthcare plans from a variety of providers.

Accepted Answer

The Affordable Care Act (ACA) established health insurance exchanges, which are marketplaces where consumers can compare and purchase standardized health insurance plans from various providers.

Question 15

The United States spends a great deal of money on acute care and insufficient amounts on the promotion of health and prevention of diseases.

Accepted Answer

The U.S. healthcare system is often criticized for its focus on acute care and treatment rather than preventive measures, leading to high costs and less emphasis on health promotion and disease prevention.

Question 16

People in higher income households are more likely than those in lower income households to report their health status as fair or poor

Accepted Answer

Higher income households typically report better health status compared to lower income households, who are more likely to report fair or poor health.

Question 17

The concept of insurance is to combine the healthcare experiences of many enrollees in order to reduce expenses for any one individual to a manageable prepayment amount.

Accepted Answer

Insurance works by pooling risks among a large group of people, allowing the costs of healthcare to be spread out, so that no single individual bears the full financial burden of their healthcare expenses.

Question 18

Employment-based health insurance is coverage offered through one's own employment or a relative's employment. It may be offered by an employer or by a union.

Accepted Answer

Employment-based health insurance is typically provided as a benefit by employers or unions to employees or their family members, offering coverage through the employment relationship.

Question 19

Medicaid provides health care services for children under the age of 10.

Accepted Answer

Medicaid provides health care services for eligible low-income individuals and families, including children under the age of 19, not just those under 10.

Question 20

Individual practice association (IPA) is a type of healthcare provider organization composed of a group of independent practicing physicians who maintain their own offices and band together for the purpose of contracting their services to HMOs.

Accepted Answer

An Individual Practice Association (IPA) is indeed a group of independent physicians who collaborate to contract with Health Maintenance Organizations (HMOs) while maintaining their own private practices.

Quiz 18: Private and Government Healthcare Systems