4 types of Health Plans
HMO
• Pay low premium
• NO Deductible
• No or Low co-pay
• Select one PCP (Primary care provider)
• Specialist needs a referral from PCP
What is Health Maintenance Organization
Health Insurance for eligible Americans age 65 or older
What is Medicare
_______ million people are uninsured
What year was the Affordable Care Act made into law and who was responsible for it?
What is 2010 and President Obama
Purchased through a larger
organization: employer, union, or
professional organization
What is group Insurance
PPO
High premium and high OOP payments
Preferred network of providers
In-network= lower cost
Out of network= higher costs
No PCP required
• No referral required
What is Preferred Provider Organization
Part of Medicare that covers inpatient hospital stays and you have to pay a deductible and co-payments
What is Plan A
The average person spends how much on healthcare cost each year
What is $12,914
Who does tri-care provide Insurnace free for?
What is Active military and dependents
Patients pay for all expenses up front. Insurance will reimburse approx 80%.
Services can be from anywhere
What is indemnity Insurance
EPO
• Limited to care from
providers/hospitals in
network
• Referral not required
• No coverage out of
network
Exclusive Provider Orginization
Part of Medicare that is for medically necessary services, preventative, mental health, ambulance, and LIMITED prescription drugs
What is Plan B
Insurance coverage that covers part or all the cost of medical or surgical procedures of the policyholder
What is Health Insurance
What 2 things does Workers Comp Insurance cover?
Person purchases a policy and
agrees to pay entire premium.
What is Individual Insurance
• POS
• Mid for HMO and PPO
• Select PCP
• Need referral for specialist
• Access to out-of-network
providers with increased cost
What is Point of Service
Part of Medicare that is like HMO or PPO and covers:
• Vision
• Hearing
• Dental
• wellness
What is Part C
What does in network provider mean?
What is a provider that is on the
list of chosen providers by an insurance company
What does the CHIP program stand for and what is it for?
What is Childrens Health Insurance Program and it provides healthcare to working families earning too little to afford insurance but too much to be eligible for Medicaid
Health insurance plan purchased through a private insurance company that covers costs not covered by Medicare- fills in the
gaps
What is Medigap policy
Name at least two of the acronyms for Health Plans.
What is PPO, HMO, POS, or EPO (only need two)
Part of Medicare that covers additional prescriptions and offers insulin at $35/month
What is plan D
What does out of network provider mean?
What is a provider that is
NOT on the list of chosen providers by an insurance
company
1/5 of Americans have this insurance
What is Medicaid
Free insurance for kids and disabled offered by the federal/state government
What is Medicaid