Health plans
What does HMO stand for?
Health Maintenance Organization
Which U.S. program provides health coverage mainly for people aged 65 and older?
Medicare
The percentage of costs of a covered health care service you pay (20%, for example)
Coinsurance
It is a patient's right to ask any questions necessary to understand how to continue their medical care?
Yes
A patient who is admitted and stays overnight.
Inpatient
What does PPO stands for?
Preferred Provider Organization
Which type of insurance plan is typically offered through employers in the U.S.?
Private Insurance
A person or entity that delivers medical care or treatment.
Provider
One of the patient's rights is "Clear understanding of coverage payments
True
Regular payment to maintain health insurance coverage.
Premium
Which type of plan typically has higher premiums when choosing out of network doctors and hospitals?
PPO
Which government program provides health coverage to low-income individuals and families?
Medicaid
Person or business who can help you apply for help paying for coverage and enroll in a Qualified Health Plan.
Broker.
Which are the Healthcare components?
Patient, Providers, Insurances
A patient who receives medical treatment without being admitted to a hospital overnight. What service is?
Outpatient
Which plan type combines features of both HMO and PPO, requiring referrals but offering some out-of-network coverage?
POS
What is the main difference between governmental insurance and private insurance?
Governmental insurance is publicly administered, while private insurance is offered by private companies.
What is the term for the amount you must pay out-of-pocket before your insurance starts covering costs?
Deductible
What is the term for the network of doctors, hospitals, and other providers that an insurance plan contracts with?
Provider Network
Medical services provided on an outpatient basis.
Ambulatory Care
What is the main difference in provider choice between HMO and PPO plans?
PPO plans allow out-of-network coverage, while HMOs generally require in-network providers.
Which type of insurance is provided to active duty military members and their families?
TRICARE
After you spend this amount on deductibles, copayments, and coinsurance for in-network care and services, your health plan pays 100% of the costs of covered benefits.
Out of Pocket
What are the 4 ways to get my medical services paid?
*Get it from private company
*Get it from employer
*Beneficiary from state
*Pay Out of Pocket
Short-term treatment for severe or urgent medical conditions
Acute Care