Medicare
Plan that includes Part A and Part B
What is Traditional Medicare
Plan that covers services and care that is necessary to treat and an emergency medical condition.
Plan that requires you to have a PCP aka a gatekeeper?
What is an HMO plan?
Tricare Prime has a Primary Care Manager and requires you to have a ________________ on file for visit to see a specialist.
What is a referral?
Person who is financially responsible for the patient account.
What is a guarantor?
Plan for Prescription coverage
What is Medicare Part D?
Plan that is provided to children 18 or under when they don't qualify for Medicaid.
What is CHIP?
Plan that offers flexibility of an HMO or PPO plan that offers in and out of network benefits.
What is a POS plan?
Health plan for Families of Veterans which provide care and shares the cost of covered healthcare services to eligible beneficiaries.
What is ChampVA?
Family members that are on an insurance plan.
What is a dependent?
Traditional Medicare Part A + Part B + Part D=
What is Medicare Part C aka Medicare Advantage Plan?
Plan that provides free women's health and family planning services to eligible, low-income Texas women.
What is Healthy Texas Women's Medicaid?
A financial assistance program that is not health insurance for Bexar County Residents.
What is Carelink?
Plan that provides Health Care and Prescription services on military installations only and on a space availability basis.
What is Tricare Direct Care?
Person who enrolls in an insurance plan
What is the subscriber?
Plan that covers the gaps that Medicare doesnt cover.
What is a Medicare Supplemental aka Medigap plan?
A cost assistance program designed to help individuals who are eligible with both Medicare and Medicaid.
What is Medicaid QMB?
Plan which is not an insurance, but a cooperative in which members agree to cover a portion of one another's medical cost.
What is a Healthshare Plan?
UH is contracted with this Tricare region
What is Tricare East Region?
The max amount of money customers pay per year.
What is Out of Pocket Maximum?
Medicare Covers ___ full days, ____ coinsurance days, with Lifetime max of _______days
What is 60/30/60?
Plan that helps children 20 and younger who have special health care needs and people with cystic fibrosis of any age improve their health, well-being and quality of life
What is CSHCN? Children With Special Health Care Needs
An insurance that will cover for on the job injury.
What is Workman's Comp?
What is Tricare for Life?
A health care professional, hospital, or pharmacy that is not part of a health plan's network of providers.
What is Out of Network?