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
