Insurance and Government programs
Medicare part A
Inpatient coverage, home health, hospice, and extended care after hospitalization
Medicare Part B
Outpatient care, physician visits, outpatient services, physical therapy, durable medical equipment, radiology, ambulance fees, and lab fees
POS
Point of Service
Medicare part D
Prescription drug coverage,
managed care plans
The insurance carrier will pay the healthcare provider directly for services, but requires you to choose from a specific network of providers
coinsurance
a fixed percentage of the cost of service that the insured must pay after they have met their deductible
Medicare
a program administered and funded by the federal government that was created to help citizens with disabilities/medical conditions or that are 65 or older(additional funding from premiums, deductibles, and coinsurance payments)
Medicaid
a program administered by state governments to help people with low income and few resources to receive medical care
Worker's compensation
administered by state governments and funded in part by employers to help those who are injured on the job
HMO(Health maintenance organization)
an organized system for providing healthcare in a specific geographic area
Group insurance
commonly available through the employer, the employer selects the plan, the employer pays part of the premium
beneficiary
family members covered under the same policy
Medicare Part C(combines a and B to create "medicare advantage")
it covers everything under parts A and B, dental care, eye glasses, hearing aids
fee-for-service plan
patient's have a greater financial responsibility, but may choose from any healthcare provider
copayment
set fee at the time of service
Monthly premium
the cost a patient pays each month for health and/or drug insurance
Insured
the patient entering into the contract
Individual healthcare plan
when a person purchases a policy, agrees to pay the entire premium, it is more expensive, and it allows for more choices