Health Insurance

Indemnity

-payment for medical services: patient has a greater financial responsibility (pay up front) -Choosing a healthcare provider: no networks. patients can go to any healthcare provider

to promote good health and practice preventative medicine.

What concepts is managed care built on?

patients must pay for all health care expenses out of their own pocket. Afterward, the insurance agency will reimburse the patient for a percentage of the expenses.

What is indemnity insurance?

individual insurance is when a person purchases a policy and agrees to pay the entire premium for health coverage. Group insurance is generally purchased through an employer. The premium is split between the employer and the person being insured.

What is the difference between individual and group insurance?

15%

What percentage of the United States gross national product is made from health care expenses?

out-of-pocket

a medical bill that must be paid by the patient

Co-payment

an amount paid by the patient for a certain service

payment for medical services, choosing a health care provider (indemnity or managed)

what are the two major differences between managed care and indemnity insurance?

Managed Care

-payment for medical services: insurance company pays for service directly -Choosing a healthcare provider: require patients to choose a specific list

to reduce the cost of medical expenses by maintaining a healthy lifestyle.

What is the goal of managed care?

Premium

the amount paid to an insurance agency for a health insurance policy

Deductible

the amount that must be paid by the patient before the insurance agency will begin to make payments