Insurance
Name 3 different types of Insurance Coverage
1. Public (Government) Coverage
2. Private (Commercial) Coverage
3. Out of pocket cost by self-
Name 2 insurance plan components
Premium| Deductible| Co-payment| Co-insurance| Out of pocket Maximum| Non-Covered Services| Provider's Network
What are 2 types of patients?
Outpatient| Emergency patient| DayCare/ Same -Day Surgery Patient| Inpatient
Who is an inpatient?
A patient who is admitted to a hospital for treatment that cannot be managed on an outpatient basis.
Name a type of public coverage
Medicare | Medicaid | CHIP | Tricare | VA
What is the Out of pocket Maximum?
An out-of-pocket maximum is the highest amount you will pay for covered health care services in a year before your insurance pays 100% of the costs.
Name the 2 Provider Types
Individual Providers & Facility Providers
True/False
Individual plans are paid for by employers
False
paid out of pocket
What is commercial coverage?
Coverage provided by private insurers rather than the government, offering financial protection and access to healthcare through employer-sponsored plans or individual purchases
What does the Abbreviation EOB mean?
Explanation of Benefits
Give an example of an individual provider
Physician| Nurse| Dr
What is a provider's network?
A provider’s network in health insurance is the list of doctors, hospitals, specialists, labs, pharmacies, and other healthcare facilities that your insurance plan has contracted with to deliver care to its members. These are also called in‑network providers.
Name a type of private coverage
Employer Sponsored | Individual
What is EOB?
Explanation of Benefits -An insurance company’s statement that describes the costs involved for visits to your doctor or services.
True/False
Group plans are purchased by employers for agents only.
BONUS POINTS *3
Give a real life example of the group plan
False
Employers (in our case, Sutherland)
What is Chad's last name?
Thomas