Which type of health insurance covers a specific set of medical services?

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Prepare for the Oregon Life and Health Insurance Exam with flashcards and multiple choice questions, complete with hints and explanations. Boost your confidence and ace your exam!

Managed care plans, such as Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs), are designed to provide coverage for a specific set of medical services. These plans often focus on preventive care and wellness, emphasizing a network of providers to control costs and improve patient outcomes.

In an HMO, for example, members must choose a primary care physician (PCP) who acts as a gatekeeper to specialty services, ensuring that a defined set of services is delivered in a coordinated manner. This model helps manage healthcare costs while prioritizing the necessary care. PPOs, while slightly more flexible in that they allow visits to non-network providers, still provide set coverage terms and often require pre-authorization for certain procedures, creating a framework for specific services under their policies.

The other types of plans mentioned do not primarily operate on this model. Fee-for-service plans allow individuals to choose any healthcare provider and pay for each service received, which means there is no restriction on the type or number of services covered. High deductible health plans are structured to have lower premiums but higher out-of-pocket costs before benefits kick in, leading to more variable coverage options. Short-term health insurance plans are typically intended for limited durations and may not cover a comprehensive range of

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