Insurance 1
What is insurance?
Insurance protects you from financial loss in risky or uncertain situations.
What is Medicare?
Medicare is a federal health insurance program for people over the age of 65.
What are insurance coverage/benefits?
The things (services, procedures, medicines) insurance can provide protection for
What is a POS plan?
"Point of Service" - primary care providers coordinate all care within the network, including specialist referrals
What are examples of cost-free women's preventative care?
Well-women visits, diabetes screening, HPV, HIV & STI testing, contraceptives, breastfeeding support, DV screening
What is co-insurance?
Patients pay a percentage of the overall charge for a given service.
What is Medicaid?
Medicaid is a state government health insurance provided for people who are low-income.
What is a co-pay?
The amount of money you pay for a medical expense, while your insurance pays the rest
What is a PPO?
You pay more, but can go to any doctor you want - prices are cheaper for in-network providers
What happened in 2010?
Patient Protection and Affordable Care Act passed
What are the three types of Medicare?
Part A - inpatient hospitalization
Part B - outpatient services (optional)
Part D - portion of prescription drug costs (optional)
What is employer-sponsored insurance?
Employer-based insurance is health insurance that is provided to you through your job.
What is a deductible?
The amount of money you pay for health care each year before your insurance starts paying for protection and care
What does "subsidized" mean?
Subsidized means that the government pays money towards a service so that it is cheaper and you pay less.
What happened in 2017?
After the uninsured dropped to lowest level (27 million from 44 million), it increased by 700,000 due to efforts to alter the ACA.
What are the purpose of ACOs (accountable care organizations)?
Provider groups take complete responsibility for the care of the patient, rather than paying for isolated services. Providers are paid for overall care and quality, not medical encounters.
What is the Medicaid program for children?
CHIP
What is a premium?
The amount of money, usually monthly, you pay for insurance
It is taken out of your salary by your employer.
What happened in 2012?
Medicaid expansion was optional for states.
What is the difference between public and private insurance?
Public insurance is provided by the government. Private insurance is something you must buy that is provided by a company.
Label as public or private insurance: Medicaid, Medicare, and employer-sponsored insurance.
Medicaid = Public
Medicare = Public
Employer-Based = Private
What is a provider network?
The doctors and health care services who work with your health insurance
What is an HMO?
You must go to doctors in the network of your insurance plan, must go to primary care “gate keeper”
What is an eligibility requirement for Medicaid?
138% of federal poverty line, level of disability, need for long-term care, or dependent of Medicaid recipient