Healthcare Systems
Canada has this category of healthcare system.
What is the National Health Insurance model?
It is represented by the term HMO. A ___________ is a type of health insurance plan that limits coverage to care from in-network doctors, usually offering lower premiums and costs in exchange for restricted flexibility.
What is Health Maintenance Organization?
The specific amount of money an insured person must pay out-of-pocket for covered expenses before their insurance policy begins to pay.
What is a Deductible?
A federal program primarily for people aged 65 or older or with specific disabilities, covering medical expenses regardless of income.
What is Medicare?
If you have an annual premium of $2400, this would be your monthly premium.
What is $200?
This healthcare model has no forms of insurance, no government assistance, and everything must be paid out of pocket. It is more commonly seen in third-world countries.
What is the out-of-pocket / uninsured model?
A _________ is a flexible health insurance plan allowing members to see any doctor or specialist, in- or out-of-network, without referrals. It is usually shortened to PPO.
What is Preferred Provider Organization?
The fixed, typically monthly, fee paid to keep coverage active, regardless of whether care is used.
What is a Premium?
A joint federal-state program for individuals with limited income and resources, which can vary by state.
What is Medicaid?
You are going to get a surgery that costs $4400. Your deductible is $2400, and you have a 50% coinsurance rate. How much will you pay?
What is $3400?
This model is based around an entirely private industry. The government has almost nothing to do with healthcare, and employees + employers pay all the premiums. It is used in Germany and named after one of their leaders.
What is the Bismarck model?
A plan with a high premium usually has a ___ deductible.
What is low?
A fixed, flat fee you pay for a specific, covered health care service—such as a doctor's visit, urgent care, or prescription refill—usually at the time of service.
What is a copay?
This is the age in which you are kicked off of your parents' health insurance plan.
What is 26?
This number is used in the conversion of annual to monthly and monthly to annual premium calculations.
What is twelve?
This system is completely government-owned. The government owns all hospitals, pays all the workers, and pays for everyone's healthcare. Taxes fund this system. It's used in England and has an appropriately English name.
What is the Beveridge model?
A tax-advantaged personal savings account for individuals with a High Deductible Health Plan (HDHP) to pay for qualified medical expenses. It offers a triple tax benefit: contributions are tax-deductible, growth is tax-free, and withdrawals for qualified medical expenses are tax-free. Funds roll over annually, and the account is portable.
What is HSA / Health Savings Account?
It is your percentage share (e.g., 20%) of the costs of a covered health care service, which you pay after you’ve met your deductible, while the insurer covers the rest (80%) up to your out-of-pocket maximum.
What is coinsurance?
A three word term that refers to big events -such as marriage, birth, divorce, or losing coverage—that allow you to enroll in or change health insurance program. It is shortened as QLE.
Qualifying Life Event
Costs for this type of service are usually different from a general practitioner or other family doctors. These doctors provide services for specific conditions and have their own unique copays and coinsurances. Examples include podiatrists and dermatologists.
What is a specialist?
The United States uses all four healthcare models for different categories of people. There are the Beveridge, Bismarck, National Health Insurance, and Uninsured Models. Which model does the VA fall under?
What is the Beveridge model?
The ____ was established under the Public Employees Insurance Act of 1971, to provide hospital, surgical, group major medical, prescription drug, group life, and accidental death and dismemberment insurance coverage to WV government employees. It is the insurance programs that teachers have.
What is PEIA?
The comprehensive health care reform law enacted in 2010. It was signed into law by President Barack Obama and is often referred to as Obamacare.
What is the Affordable Care Act?
This disease allows you to qualify for Medicare underneath the age of 65. It is shortened as ESRD.
What is End-Stage Renal Disease?
There are two categories of health insurance that are usually split away from regular coverage. You must often purchase them separately and pay an additional premium to have their coverage. They are considered "supplemental" services.
What is vision and dental?