insurance quiz simple

income cut off for medical

-Adults qualify for Medi-Cal with a household income of less than 138% of federal poverty level.

difference between ppo and hmo

-An HMO gives you access to CERTAIN doctors and hospitals within its network. A network is made up of providers that have agreed to lower their rates for plan members and also meet quality standards; care under an HMO plan is covered only if you see a provider within that HMO's network. (fck hmo's btw) -PPO:A type of health plan where you pay less if you use providers in the plan's network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost. tldr: HMOs tend to be more affordable, but you'll usually get less coverage and more restrictions. PPOs are more flexible and provide greater coverage, but come with a higher price tag and probably a deductible. https://www.medmutual.com/For-Individuals-and-Families/Health-Insurance-Education/Compare-Health-Insurance-Plans/HMO-vs-PPO-Insurance.aspx

eligibility for medicare

-Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). -You qualify for full Medicare benefits at age 65 or older if: You are a U.S. citizen or a permanent legal resident who has lived in the United States for at least five years

out-of-pocket maximum

-The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits.

tricare insurance

-a health care insurance system for military dependents and members of the military services that covers care not available through the usual U.S. military medical service or public health service facilities.

affordable care act

-known as obamacare -law passed to expand Medicaid programs and to make health insurance available to more people

difference between copay and coinsurance

Coinsurance, like a copayment, is a form of cost sharing for health services or prescription drugs between insurance companies and the insured. Unlike copays, which are flat fees, coinsurance is a percentage of the cost for a health service or prescription drug paid by a member after they have reached their deductible. -tldr: copay = flat fee; coinsurance = % of cost for health service after they reached their deductible

bonus nice to know: difference between medicare and medical (medicaid)

Medicare is a federal program that provides health coverage if you are 65 and older or have a severe disability, no matter your income. Medicaid is a state and federal program that provides health coverage if you have a very low income.

deductible

The amount you pay for covered health care services before your insurance plan starts to pay.

copay/coinsurance

co-pay: fixed amount the insured need to pay for covered health services after paying the deductible -Coinsurance: The percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible.