Ben (age 40) pays a low ($15) co-payment each time he visits a doctor or hospital. Other than the low per-service deductible, there is very little cost sharing. However, Ben has a relatively low deductible, has no exclusions, and does not have to file insurance claims. Which of the following most likely provides Ben's health coverage?

Question

Quizplus · Accepted Answer

The characteristics described, such as a low co-payment for services, little cost sharing beyond the deductible, no exclusions, and not having to file insurance claims, are typical of a Health Maintenance Organization (HMO). HMOs often provide comprehensive health services to their members for a fixed, prepaid fee, emphasizing preventive care and requiring members to use a specific network of doctors and hospitals.

Ben (Age 40) Pays a Low ($15) Co-Payment Each Time