An insured is anxious to get treatment for a health condition, and is convinced that a specialist is needed to cure the condition. If the insured has a PPO plan, which of the following is true?

An insured is anxious to get treatment for a health condition, and is convinced that a specialist is needed to cure the condition. If the insured has a PPO plan, which of the following is true?



a). The insured visit a specialist in-network without consulting a primary care physician, but the out-of-pocket cost will be greater without the primary care physician's referral

b). The insured will have to pay all costs for the specialist out-of-pocket if a primary care physician referral is not obtained

c). The insured can select any specialist, but non-network specialist will have higher out-of-pocket costs

d). The insured must visit a primary care physician who will provide a referral to a specialist if the condition require one.



Answer: c). The insured can select any specialist, but non-network specialist will have higher out-of-pocket costs

Comments

Post a Comment

Popular posts from this blog

Give the von Neumann-Morgenstern utility function.

  Give the von Neumann-Morgenstern utility function. A utility function has expected utility propety if u(g)=∑p_{i}u(a_{i}) for any g∈G where (p₁°a₁,...,p_{n}°a_{n}) is the simple gamble induced by g. The von Neumann-Morgenstern utility function is typically denoted as � ( � ) U ( x ) , where � x represents an outcome or a set of outcomes. This utility function satisfies the expected utility property, which states that for any gamble � g with associated probabilities � � p i ​ and outcomes � � a i ​ , the utility of the gamble � ( � ) u ( g ) is equal to the sum of the probabilities weighted by the utility of each outcome: � ( � ) = ∑ � � � ⋅ � ( � � ) u ( g ) = ∑ i ​ p i ​ ⋅ u ( a i ​ ) Here: � ( � ) u ( g ) represents the utility of the gamble � g . � � p i ​ is the probability associated with the outcome � � a i ​ . � ( � � ) u ( a i ​ ) is the utility of the outcome � � a i ​ . The sum is taken over all possible outcomes of the gamble. This property essentially captures ...
Read more

Life income joint and survivor settlement option guarantees

Life income joint and survivor settlement option guarantees a) Income for 2 or more recipients until they die. b) Payment of interest on death proceeds. c) Payout of the entire death benefit. d) Equal payments to all recipients. Answer: a) Income for 2 or more recipients until they die.
Read more