Types of Health Insurance
A type of medical plan in which coverage is provided to participants through a network of selected healthcare providers.
What is a PPO plan, or Preferred Provider Organization?
Typically the first person you speak to if you have a health concern, they practice general healthcare, addressing a wide variety of health concerns for patients.
What is a PCP, or Primary Care Physician?
What is HIPAA, or the Health Insurance Portability and Accountability act?
This portion of your Medicare helps cover Medical Services like doctors' services, outpatient care, and other medical services.
What is Medicare Part B?
The time frame that someone is able to enroll in ACA coverage on the federally facilitated Marketplace, usually called "Open Enrollment".
What is November 1st to January 15th?
A type of health insurance plan that limits coverage and care to contracted doctors.
What is an HMO plan, or a Health Maintenance Organization?
A fixed amount you pay for a covered service.
What is a copayment?
This landmark legislation, enacted in 2010 aimed to increase the quality and affordability or health insurance, expand Medicare eligibility, and provide subsidies to help individuals and families afford insurance coverage.
What is the ACA, or Affordable Care Act?
Bonus Point: What year did they extend parents being able to cover their children up to the age of 26?
The portion of your Medicare that covers inpatient hospital care, skilled nursing facility, hospice care, and some home health care.
What is Medicare Part A?
The time frame when someone is able to change, drop, or enroll in a Medicare Advantage Plan & Part D Plan, usually called the "Annual Enrollment Period".
What is October 15th to December 7th?
These types of plans have lower premiums, higher deductibles, and allow the client to be eligible for an HSA.
What is a HDHP, or High Deductible Health Plan?
The amount that you pay for covered health expenses before your insurance plan starts to pay.
What is a deductible?
Passed in 1985 , this law allows eligible employees and their dependents to continue health insurance coverage temporarily after losing coverage due to job loss, reduction in work hours, or certain other qualifying events.
What is the Consolidated Omnibus Budget Reconciliation Act, or COBRA?
What is a Medicare Advantage Plan?
A time outside of open enrollment when you can sign up for health insurance coverage.
What is a Special Enrollment Period?
Bonus Points:
+100 points for each life event that qualifies you for a special Enrollment Period.
A hybrid health insurance plan in which a primary care provider is not necessary, but health care providers must be seen within a predetermined network.
What is an EPO plan, or an exclusive provider organization?
While not a bill, this outline shows you the total charges of your visit.
What is an EOB, or Explanation of Benefits?
Enacted in 2008, this law requires health insurance plans to provide coverage for mental health and substance use disorder services that is comparable to coverage for medical and surgical services.
What is the Mental Health Parity and Addiction Equity Act, or MHPAEA?
A type of Medicare Health Plan that is federally regulated to provide the same coverage, no matter the provider.
What is a Medicare Supplement or Medigap Policy?
The time frame that you are able to change or drop your existing Medicare Advantage plan OR enroll in Part A or Part B if you missed it.
What is a Medicare Open Enrollment Period or General Enrollment Period?
(Points for either or both)
A type of managed-care health insurance plan that provides different benefits, depending on whether the policyholder uses in-network or out-of-network healthcare providers.
What is a POS plan, or "Point of Service?"
A type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses.
What is an HSA, or Health Savings Account?
Passed in 1986, this law requires hospitals that participate in Medicare to provide emergency medical treatment to anyone who needs it, regardless of their ability to pay, citizenship status, or other factors.
What is the Emergency Medical Treatment and Active Labor Act, or EMTALA?
A voluntary, outpatient prescription drug benefit for people with Medicare provided through private plans that contract with the federal government.
What is a Prescription Drug Plan, PDP, or Part D?
The time frame that you are able to enroll in a Medicare Supplement or Medicare Advantage Plan for the first time.
What is 6 months before and after the month you turn 65?