What is a ppo plan Study guides, Class notes & Summaries

1. Which of the following would not be accomplished with the purchase of an insurance policy? ANS Risk is eliminated 2. Individuals become eligible for Medicare Part A benefits at what age? ANS 65 3. At what point does a self-insured group qualify for a stop-loss coverage? ANS - When claims exceed a specified limit in a set period of time 4. What percentage of eligible employees must participate in a noncontributo- ry group health plan before it can be put in effect? ANS 100% 5. In a li...

AHIP 2023/2024 FINAL EXAM REAL Q&A EXPERT VERIFIED GUARANTEED PASS LATEST UPDATE. Ramos is considering a Medicare Advantage PPO and has questions about which providers she can go to for her health care. What should you tell her? Mrs. Ramos can obtain care from any provider who participates in Original Medicare, but generally will have a higher cost-sharing amount if she sees a provider who/that is not a part of the PPO network. Romero is 64, retiring soon, and considering enrollment in his emplo...

AHIP FINAL EXAM QUESTIONS AND DETAILED ANSWERS MARCH 2024 LATEST GRADED A+. Mr. Davis is 52 years old and has recently been diagnosed with end- stage renal disease (ESRD) and will soon begin dialysis. He is wondering if he can obtain coverage under Medicare. What should you tell him? Correct Ans - He may sign-up for Medicare at any time however coverage usually begins on the fourth month after dialysis treatments start. Juan Perez, who is turning age 65 next month, intends to work for seve...

deWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition MULTIPLE CHOICE 1. Which statement accurately describes the primary purpose of the state nurse practice act (NPA)? a. To test and license LPN/LVNs. b. To define the scope of LPN/LVN practice. c. To improve the quality of care provided by the LPN/LVN. d. To limit the LPN/LVN employment placement. ANS: B While improving quality of care provided by the LPN/LVN may be a result of the NPA, the primary purpose of the NPA of each state d...

Medical billing and coding latest version graded A+ Medical Insurance Financial plan (the payer) that covers the cost of hospital and medical care Policyholder Person who buys an insurance plan; the insured, subscriber, or guarantor Health Plan Individual or group plan that provides or pays for the cost of medical care Benefits What a health plan pays for services covered in an insurance policy; listed in the schedule of benefits. Medical Necessity Reasonable services of prov...

Virginia Life and Health Exam Review. Questions with accurate answers. 2022/2023. Document Content and Description Below Virginia Life and Health Exam Review. Questions with accurate answers. 2022/2023. What contract term means only one party to a contract's promises are legally enforceable? - Unilateral Mr. Jones, the insured, committed suicide after the expiration of the suicide clause in his life insurance policy. The insurer is obligated to: - Pay the death benefit. The benefit that encou...

CISR LIFE & HEALTH Exam 52 Questions with Answer The first step in understanding the elements of a life insurance contract is being able to: A) describe the personal and specific reasons people purchase life insurance B) describe the different parties to a life insurance contract and their relationship - CORRECT ANSWER B) describe the different parties to a life insurance contract and their relationship A policy owner has the power to: A) Name one or more beneficiaries B) Change th...

AHIP Final Exam Latest Questions and Answers 2024 (verified answers) Mr.Gomez notes that a Private Fee for Service (PFFS) plan avaliable in his area has an attractive preminum. He wants to know if he must use doctors in a network as his current HMO plan requires him to do. What should you tell him? - ANSWERS He may receive health care services from any doctor allowed to bill Medicare as long as he shows the doctor the plan's identification card and the doctor agrees to accept the PFFS...

AHIP Final Exam 2024 Test Questions and Answers 100% Verified Mrs. West wears glasses and dentures and has enjoyed considerable pain relief from arthritis through acupuncture. She is concerned about whether or not Medicare will cover these items and services. What should you tell her? Medicare does not cover acupuncture, or, in general, glasses or dentures. Mr. Bickford did not quite qualify for the extra help low-income subsidy under the Medicare Part D Prescription Drug program and he...

AHIP Practice Exam Questions and Answers 100% Correct Mr.Gomez notes that a Private Fee for Service (PFFS) plan avaliable in his area has an attractive preminum. He wants to know if he must use doctors in a network as his current HMO plan requires him to do. What should you tell him? - Correct Answer ️️ - He may receive health care services from any doctor allowed to bill Medicare as long as he shows the doctor the plan's identification card and the doctor agrees to accept the PFFS pl...