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14 Cards in this Set
- Front
- Back
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HMO |
Health Maintenance Organization |
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What is HMO (Health Maintenance Organization)? |
- Choose 1 Primary Care Provider (PCP), they refer to specialist - All your care if coordinated through that PCP |
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PPO |
Preferred Provider Organization |
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What is PPO (Preferred Provider Organization)? |
- Insurance company allows you to hoist from particular MD's *Tell - Decide PCP *Choose Specialist |
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What is Medicare? |
Health insurance for 65 and older + disabled (diseases such as Alzheimer's). |
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What is Medicaid? |
Health insurance for lower income families. |
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What is a premium? |
What you pay monthly for health insurance. |
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What is a deductible? |
What you have to pay before insurance will start to cover it. |
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What is a copay? |
Set dollar amount for a particular service. |
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What is coinsurance? |
When the health insurance company pays a percentage of your medical bill after you pay your deductible. |
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What is OOP? |
Means Out of Pocket. Money amount before insurance pays. |
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What is OOP Max? |
Max amount of money paid before insurance covers 100%. |
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Name the main rights listed in the Affordable Care Act - 2010 Universal Healthcare? |
1. Everyone must have healthcare or pay fines. 2. Ages 26 and younger may stay on parents insurance. 3. No denial of pre-existing conditions. 4. Small businesses must provide coverage to >12 employees. |
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BCBS Gold Deductible: $5,000 ED: 50% PCP: $10 Specialist: $100 Prescription: 80% Premium: $275 How much does this patient owe before HI benefits are paying on a bill? One this patient has met their deductible, they owe $1,275, how much do they pay? |
1. $5,000 2. $637.50 |
