Medicare
for hospital care
part A
insurance for those over the age of 65
Medicare
covers patients with work related injuries
worker's compensation
family members covered by the insurance policy
dependents
patients stay here limited time to receive PT/ OT/ other therapy services
Rehabilitation facility
do not pay a premium as long as you contribute 10 years to social security
Part A
insurance for those that have very low income
Medicaid
combination of PPO and HMO
Point of Service (POS)
a list of charges for specific medical services and procedures
fee-schedule
outpatient surgical procedures
surgery center
Covers prescription drugs
Part D
insurance for those disabled, or with end stage renal disease
Medicare
insurance with strict guidelines and narrow choice of providers
HMO
policy holder contributes to insurance by paying a set amount of money each month/ paycheck
premium
private practice physicians join together to offer discounted rates or rates based on capitation to members
independant practice association
a.k.a. Medicare Advantage Plan
Part C
insurance for active members of the armed forces and retired personnel and their families
TRICARE
most popular type of private insurance, greater choice of providers.
PPO
calculated based on a percentage of a charge ex. 80/20
coinsurance
outpatient care, can be specialized care or care offered at low or no cost
ambulatory clinic
Covers outpatient services and DME
Part B
insurance for veterans with service related disabilities
CHAMPVA
employers pay directly for employee's medical bills
self-insure
set amount a patient has to pay before they can receive benefits or insurance company beings to pay
deductible
Mrs. Smith is referred to as a resident and requires help with ADLs
nursing home