Types of Coverage
A health care plan obtained through the government such as Medicare, Medicaid or Veterans affairs is called a _____ health care plan.
Public
Medicare is only available to Americans this age and above.
65
This is the Name of Oregon's Medicaid provider.
Oregon Health Plan (OHP)
Amount an individual must pay for covered health services received prior to their plan begins to pay.
Deductible
The name of Samaritan Health Plan's Medicaid CCO.
Intercommunity Health Network (IHN).
A health plan obtained through a employer or purchased through a marketplace is called a ___ health care plan.
Private
This part of Medicare Covers emergency room visits and hospitalizations.
Part A
This organization is responsible for managing and regulating Oregon's Medicaid plan, as well as its broader healthcare infrastructure.
Oregon Health Authority (OHA)
A fixed amount an individual will pay for a covered health care service after they’ve paid their deductible.
Copay
Intercommunity Health Network's service area covers these three counties.
Linn, Benton and Lincoln
All Samaritan Medicare Advantage Health Plans are this 3-letter plan type.
HMO
This Part of Medicare covers Doctor's visits, imaging, x-rays, labs and other standard medical care.
Part B
This 3-letter plan type is a local organization that manages Medicaid plans for members in a specific county areas in the state of Oregon.
CCO
The percentage of the cost of a covered health care service an individual pays after paying their deductible.
Co-Insurance
Customer Service Reps should put themselves in this status in Five9 when they are in training.
Training/Education
This type of health plan provides coverage offered and managed by an employer. Employer and Employee contribute to policy via payroll deduction. Are still regulated by the federal government but are usually not subject to state laws.
Self-Insured
This part of Medicare is also called a "Medicare Advantage Plan," where a Medicare beneficiary pays a private insurer to manage their Medicare in exchange for benefits that go beyond standard Medicare Benefits.
Part C.
Medicaid plans are only available to Americans who fall into 4 qualifying categories.
Low income, children, pregnant and disabled
The premium is an amount of money a consumer pays for a health insurance plan. The consumer and/or their employer usually make this payment bi-weekly, monthly, quarterly, or yearly.
Premium
In the event of an emergency and a Customer Service Rep needs to leave early, they should contact this person and not their trainers to request excusal.
Olivia
This type of health plan provides coverage purchased by an employer from a company, or a Medicare/Medicaid plan.
Fully Funded
This part of Medicare covers prescription drugs.
Part D
The Oregon Medicaid Coverage package that covers Medical, Mental and Dental Health.
CCOA
The most a consumer could pay during a coverage period (usually one year) for their share of the costs of covered services. After the consumer meets this limit, the plan will usually pay 100% of the allowed amount.
Out-Of-Pocket Maximum
Customer Service Reps use this phone number to Call out or in late at least 30 minutes prior to their shift.
541-768-7899