Insurance and Government programs

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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


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