Insurance Basics
What is the main purpose of insurance?
To provide financial protection against risks or unexpected events.
What is a healthcare provider?
A provider is any health professional or facility that delivers medical care, such as doctors, hospitals, nurses, and specialists.
This U.S.-based company provides managed care services through government programs.
Centene
What is the Health Insurance Marketplace?
Online platform for health plans
What type of insurance provides financial support to beneficiaries after a person’s death?
Life Insurance
What are the three main types of providers?
Primary Care Physician, Specialist, and Facilities
This is Centene’s health insurance brand offered through the Marketplace.
Ambetter
What law created the Marketplace?
Affordable Care Act (ACA)
Which type of insurance protects your vehicle against accidents, theft, or damage?
Auto Insurance
What is the role of a Primary Care Physician (PCP)?
A PCP is usually the first point of contact and provides preventive care, treats common illnesses, and promotes overall health.
This benefit covers ER visits even without prior authorization.
Emergency Services
What are the two enrollment periods?
AEP and SEP
Name at least two types of insurance discussed in the training.
Life, Auto, Homeowners, Renters, Disability, Business, or Health Insurance
What is the difference between a primary care provider and a specialist?
Primary care providers handle general health needs, while specialists focus on specific areas of medicine and more complex conditions.
These plans have the lowest premiums but the highest out-of-pocket costs.
Bronze Plans
What is an On-Exchange plan?
Marketplace plan with subsidies
What are the three types of health insurance plans in the U.S.?
Employer-Sponsored, Individual, and Government Programs
Give at least three examples of specialists.
Cardiologist, Dermatologist, Radiologist, or Neurologist
Give one example of Ambetter Health Member Exclusive Programs.
Mail-Order Pharmacy Program
24/7 Nurse Advice Line
Health Management Programs for Chronic Conditions
Care Management Services for Complex Health Needs
Walgreens Smart Savings
Start Smart for Your Baby Pregnancy Program
Ambetter Perks Member Discount Program
My Health Pays
Dispatch Health
Stay Healthy Zone
Virtual 24/7 Care
What is an Off-Exchange plan?
Private plan without subsidies