1
This is a practice or arrangement between 2 parties by which a company or government agency provides a guarantee of compensation for specified loss, damage, illness or death in return for a payment.
Insurance
These are services given to a patient whose condition needs to be attended immediately. Failure to do so results to loss of life, serious medical complications or permanent disability
Emergency Care
This service is aimed at helping patients recuperate from a variety of injuries and illnesses. It’s usually performed during the patient’s convalescence after surgery if any.
Rehabilitative Services
The amount of money a customer hands to the insurer periodically for health insurance coverage.
Premium
Is the general term used by the insurance company to address its customers or policy holders.
Member
Are providers who have contracts with the insurance company at the time the services are rendered
Participating Providers / In Network Providers
These are any equipment used by a patient that can provide therapeutic relief/ benefits to a patient who has a medical condition or illness.
Durable Medical Equipment (DME)
The amount of protection given by an insurance policy to an individual.
Coverage
This type of care is for a patient who requires a stay in a hospital or other healthcare facilities for more than 24 hours.
Inpatient Care
These are tests performed to a patient to assist in the diagnosis or detection of a disease.
Diagnostic Services
Give 1 other qualification for Medicare aside from age.
Under 65 years old with certain disabilities.
All ages with End Stage Renal Disease (ESRD) for over 30 months.
Health insurance is a type of insurance that financially covers the whole or a part of the person’s hospital, surgical or medical expenses in return for a _______.
Payment
The payer will only cover services rendered by in-network providers and specialist visits must have a referral from the assigned PCP. PCP must also be participating of the network.
HMO
What Part of Medicare covers a member for any “inpatient” stays – Medical Hospital, Skilled Nursing Facility, Hospice, Home Health Care etc.
Part A
The payer will cover services rendered by in and out of network providers. Specialist visits doesn’t require referrals and no PCP assignment is required.
PPO
What is an artificial device used to correct the alignment or provide support.
Orthosis
What is the other term for Medicare Part D?
Prescription Drug Plan
What is required for an individual to be eligible for Medicare Part C?
Medicare Part A and B
A Type of Insurance that is designed for the most vulnerable lower-income individuals and jointly funded by the federal and state governments
Medicaid
Which Medicare part helps the member pay for medical services – Doctor visits, lab tests, outpatient hospital services and other like services?
Medicare Part B
The payer will cover services rendered by in and out of network. providers however if the specialist visit is rendered by an INN provider, it requires a referral from the assigned PCP. PCP must be part of the network.
POS
Who signed the Affordable Care Act in the year 2010?
President Barack Obama
These are any equipment used by a patient that can provide therapeutic relief/ benefits to a patient who has a medical condition or illness.
Durable Medical Equipment
A facility or program that is created to provide a nurturing environment for meeting the physical and emotional needs of a terminally ill patient.
Hospice
This program is designed to allow certain individuals to qualify for Medicaid coverage even though they receive income more than eligibility requirements.
Spend Down Program