Medicaid
The income level used by the federal government to determine if an individual or family qualify for government health insurance
What is the Federal Poverty Level
The part of the plan that handles expenses associated with hospitalization
What is Medicare Part A
Don't need a referral to go outside of the network
What is POS and PPO
A payment model where providers are paid for each service delivered (e.g., exam, test, procedure)
Fee For Service
Patients on both Medicaid and Medicare are considered
What is Dual Eligible
The part of plan that handles expenses associated with In-office procedures, durable medical equipment, out-patient care
What is Medicare Part B
POS stands for
What is point-of-service plan?
Cost Containment Tool where provider receives a salary as an employee of an MCO
Performance Based Salary Bonuses and witholdings
Medicaid covers people who fall into the following categories
Who are lower income, older adults, People with disabilities, Children, Pregnant people, Parents and/or caretakers of children
Medicare coverage gap is also known as
The donut hole
In an HMO, there are higher costs associated with using these types of providers
What is out of network?
Insurance exist because of these two concepts
Uncertainty and Risk
This U.S. President signed Medicaid into law
Who is Lyndon B. Johnson?
The age you need to be if you do NOT have a permanent disability to qualify
What is 65
PPO stands for this
What is preferred provider organization
Companies considering applicant's medical history or other personal information to help assess risk of healthcare needs in the future
What Is Medical Underwriting?
This provision in the Affordable Care Act allowed states to expand Medicaid eligibility to more low-income adults.
What is Medicaid Expansion?
Part of Medicare plans that allows private health insurance companies to provide Medicare benefits.
Part C Medicare Advantage
Requires you to choose a primary care provider
What is HMO
What is 8%?