Terminology
What is an appeal?
A reconsideration of a denied service.
What is Medicaid?
A program that is for individuals and families with low incomes and resources.
What does Medicare Part D covers?
It covers the cost of prescription drugs
What does SDOH stand for?
Social Determinants of Health
What age are you required to get off of your parents health insurance policy?
26
What is a Co-pay?
A dollar amount that an insured individual must pay out of pocket for services at a doctor's office.
What is the Medicaid program for children?
CHIP (Children's Health Insurance Plan)
What services does Medicare part B cover?
It covers outpatient healthcare services, services by pcp and dme, or durable medical equipment.
What does FFS stand for?
Fee for Service
What is the name of the federally funded health insurance program available mainly to people over 65 and to people with certain disabilities?
Medicare
What is the term for a specific amount of money that must be paid yearly before the benefits begin?
Deductible
How often does a Medicaid recipient needs to reapply for Medicaid?
Once a year
What is the term used for an individual who is eligible for Medicare and Medicaid?
Dual Eligible
What does VA stand for?
Veteran's Administration
What is a form of insurance that provides payment for medical care when a person in injured on the job.
Worker's Compensation or (LNI)
What is the term for the amount you pay each month to belong to a health plan?
Premium
What is the government agency responsible for Medicaid?
HCA
Another name for a Medicare Advantage plan
Medicare Part C
What does ESRD stand for?
End Stage Renal Disease
What is an out-of-pocket maximum?
It is the most you'll pay for covered healthcare services in a year, after which you insurance plan covers 100% of the eligible services for the rest of the year.
What is an Explanation of Benefits (EOB)?
A document sent by an insurance carrier to a patient explaining what was covered for a medical service.
What year was Medicaid created as part of the Social Security Act?
1965
What are the three ways to qualify for Medicare benefits?
Age, Disability and ESRD
What does FPL stand for?
Federal Poverty Level
Which of the following types of health insurance is provided by employers?
A. Group health insurance
B. Individual health insurance
C. COBRA
D. Hospital indemnity policy
A. Group health insurance