Under one type of Medicare Advantage Plan, members of the plan ...

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Under one type of Medicare Advantage Plan, members of the plan can see any doctor or health services provider that accepts Medicare patients.
 
  If members receive care outside the network of member physicians and care facilities, they must pay higher out-of-pocket costs. This type of Medicare Advantage Plan is a
  A) Medicare HMO.
  B) Medicare PPO.
  C) Medicare Special Needs Plan.
  D) Medicare Private Fee-for-Service Plan.

Question 2

Under Part A of Medicare, how is reimbursement for inpatient hospital care determined?
 
  A) The amount billed to Medicare by the hospital is the amount Medicare pays.
  B) Eighty percent of the hospital's regular charge for care is paid.
  C) The hospital's usual, reasonable, and customary charge is paid.
  D) Hospital care is classified into diagnosis-related groups (DRGs) and the amount reimbursed depends on the DRG classification of the care delivered.

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Answer to Question 1

Answer: B

Answer to Question 2

Answer: D