Health insurance

What are the two government programs that help those without health insurance

Medicaid and Medicare

What is Medicaid

Need a base program... Have to buy state-by-state; provides medical assistance to individuals and families who are determined by the state to be "needy"

Out - of - pocket

A medical bill that must be paid by the patient

Individual insurance

A person purchases a policy and agrees to pay the entire premium for health coverage

What is Medicare

Any citizen age 65 or older... After an individual pays a deductible, but this will cover 80% of all medical expenses

What does a PPO do

Clients do not have to choose a primary care physician, clients may visit non-- network positions; but coverage is greater with in-network positions... They have higher premiums

What does a HMO do

Clients must visit in network doctors and select a primary care physician..... If the person receives medical services from a physician that is not in the network, they will not cover the expenses

Group insurance

Generally purchase through an employer. The premium is split between them foyer in the person being insured

What are indemnity plans

Greater financial responsibility and must pay out - of - pocket then wait for reimbursement

What is reimbursement

Hope insurance agencies do not always do this the amount charge for services.... Physicians will either "absorb" the loss, or they will charge the patient for the valve that was not paid by the insurance agency

What is part a in Medicare

Hospital care... Hospitalization, skilled nursing facilities, home health care, hospice care, Long - term care facilities

What does managed care dude that indemnity plans don't do

Insurance pays directly for medical service... However in both types, the patient may be required to pay the yearly deductible

What is managed care

It offers reduce rates for medical service through a network of healthcare providers

What is part B in Medicare

Outpatient services... Medical expenses, including therapy, medical equipment, and testing... Preventive care

Is health coverage offered by private or public health insurance agencies

Private

What type of government is in charge of Medicaid

State government

Co-payment

The amount paid by the patient for a certain service

Premium

The amount paid for an insurance agency for a health insurance policy (paid monthly)

Deductible

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

What type of government does Medicare cover

The federal government

What are socioeconomics

The study of how economics is affected by society, culture, and politics... Revealed the need for medical assistance for the elderly, disabled, and poor

What are the two concepts of managed care

To promote good health into practice preventive medicine... Third goal is to reduce the cost of medical expenses by maintaining a healthy lifestyle