Affordable Care Act
Insurance
Rules and Regulations
Medicare
100

They are a category of illness on the basis of which an insurance company may not deny or charge more for coverage.

What are...
a) Sexually transmitted infections?
b) Pre-existing conditions?
c) Malignancies?
d) Mental illnesses?

What are Pre-existing Conditions?

*Including being a woman

100

It is a set number of dollars that the patient pays for every healthcare encounter.

What is a Co-pay?

100

It is a law that requires clinicians to keep patients' health care information private (among other things).

What is HIPAA?

100

It is the Medicare program that covers hospital stays.

What is Medicare Part A?

200

This is where uninsured patients can shop for private insurance plans.

What is The Marketplace?

200

It is your and/or your employer's monthly payment to the insurance company.

What is a Premium?

200

It is a law that requires emergency departments to evaluate and stabilize a patient or patient in labor without regard to the patient's ability to pay.

What is EMTALA?

200

It is the Medicare program that covers outpatient services.

What is Medicare Part B?

300

It allows young adults to remain covered as dependents on their parents' health insurance policies until a specific age.

What is the the age 26 extension?

300

It is a set number of dollars that the patient must pay for healthcare services before the insurance company will begin paying.

What is a Deductible?

300

It prohibits billing patients for out-of-network services provided in an otherwise in-network facility.

What is the No Surprises Act?

300

It is the Medicare program that covers prescription drugs.

What is Medicare Part D?

400

It is a class of services that insurers must cover with no out-of-pocket costs for the patient.

What are Preventive Care Services?

400

It is a set percentage of the cost of the healthcare encounter that the patient pays.

What is Co-insurance?

400

It is a law that imposes civil liabilities on those who knowingly submit false claims to the federal government for reimbursement, e.g. Medicare/Medicaid Fraud

What is the False Claims Act?

400

It is a Medicare program that pays a commercial insurance company to administer a patient's Medicare insurance benefits.

What is Medicare Advantage?

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