Health insurance

Out out network

A healthcare provider that does NOT have a contract with the insurance company, cost is at high premium prices for the subscriber.

Medicaid

A type of insurance that persons who are disabled or low-income can benefit from.

What is managed care?

Managed care is a type of insurance plan that puts health care providers in the position of managing a patient's use of health care. Managed care plans have contracts with providers that set predetermined rates for services.

health care cost containment

Measures to control health care costs and create an affordable health care system.

How do most Americans obtain health insurance?

Most Americans obtain health insurance through their place of employment.

The money a patient must pay before an insurance policy provides benefits.

deductible

People use this type of payment when their insurance doesn't cover all health care costs, when they don't have health insurance, or when they don't qualify for a government plan.

direct payment

The monthly amount paid to a private insurance company for health insurance coverage.

premium

In-network

A healthcare provider or facility that has a contract with the insurance company, cost is negotiated down for you, the subscriber.

What are DRGs? How do they affect the amount paid to providers for health care services?

DRGs, or diagnostic related groups, are a classification system used to determine payment for health services based on diagnosis. Patients' diagnoses, treatments, surgical procedures, and follow-up care are paid according to standard fees, regardless of the actual cost of care.

How is health care paid for in the U.S.?

Health care in the U.S. is paid for through private insurance, direct payments, and government-funded plans.

Tricare

Provides health care coverage to active and retired military personnel and their dependents

List major factors causing a rise in health care costs.

Rising drug, technology, and professional costs, along with an aging population, are major factors contributing to a rise in health care costs.

Medicare

The type of insurance that persons over the age of 65 can benefit from.

A flat fee paid by the patient directly to the service provider each time the patient receives a health care service.

co-pay

Medicare, Medicaid, and TRICARE are all

government plans