Chapter 10 Know This

What is the primary financial advantage of accepting a larger upfront share of medical costs before your coverage kicks in?

Lower premium

What proactive approach to medicine is the primary emphasis of a Health Maintenance Organization?

Preventive care

In certain managed care plans, who is responsible for controlling overall costs by directing patients to specialists only when necessary?

A gatekeeper

Which health plan model offers greater freedom to see non-contracted doctors, but requires higher subscriber payments in return?

PPOs

What is the direct financial benefit to the patient when they choose to receive care from a contracted medical professional?

Lower out-of-pocket costs

What is the financial consequence for a patient who seeks treatment from a facility that does not have an established agreement with their plan?

Higher out-of-pocket cost