Insurance - Health Insurance, Medicare & Medicaid

Front 1

What are the the three major types of managed care plans

Back 1

Health maintenance organization, PPO, preferred provider and point of service plans. All managed care plans provide a primary care physician or gatekeeper

Front 2

What is a health reimbursement arrangements?

Back 2

Employees are reimbursed for medical expenses by employer

Front 3

What are the qualifying events under COBRA?

Back 3

18 months=terminated employees or conv to part tieme
29 months= disabled
36 months=MDs; medicare eligibility; Death; Dependents;; Deletion of plan; Divorce

Front 4

How long does an employee have to elect COBRA

Back 4

60 days. Once elected, the employee or beneficiary has 45 days to pay the premium

Front 5

Which employers must offer COBRA

Back 5

All employers with 20 or more employees

Front 6

What is HIPPA

Back 6

Health Insurance Portability and Accountability Act of 1996-provides that there cannot be enforcement of a preexisting medical condition if employee was covered by the prior employer's health insurance plan for at least 12 months; fewer than 63 days have elapsed since the loss of coverage

Front 7

What is Obamacare, PPACA

Back 7

beginning in 2014, people who are not eligible for other insurance must maintain certain minimum levels of health care coverage or be subject to a penalty., prohibits lifetime coverage limits for essential health benefits, and requires plans to provide preventive services without charging deductibles, copayments or coinsurance.

Front 8

What is Medicare

Back 8

federal government health insurance plan that covers individuals 65 and over, who have been receiving SS disability benefits for at least 24 months, who are on kidney dialysis treatment

Front 9

What is the breakpoint in a major medical policy?

Back 9

This is the dollar amount of covered expenses after which the insurer pays 100% up to the maximum limit of the policy. It is a combination of the deductible and stop-loss limit.

Front 10

What is first-dollar coverage?

Back 10

Also called basic coverage-hospital and surgical expense coverage that requires the insurance company to pay the first costs that are insured without being subject to a deductible.

Front 11

Are health care premiums deductible?

Back 11

Yes Included in Sch A and deductible if all medical expenses exceed 10% or 7.% % of AGI Self employed persons can deduct 100% of the cost of health insurance from their gross income for federal tax purposes.

Front 12

How does contributions to a health savings account appear on tax return

Back 12

Above the line deduction

Front 13

Is there a premium for Medicare part A

Back 13

Yes but if you have 40 or more quarters of medicare covered employment you do not have to pay for it. The premium is $248 for 30-39 quarters and $451 for less than 30 quarters.

Front 14

What is not covered under Medicare Part B

Back 14

routine immunizations, cosmetic surgerys unless needed due to an accident, dental care, eyeglasses, hearing aids, orthopedic shoes and routine foot care.

Front 15

Name some types of medical insurance

Back 15

physicians, surgical, and hospital

Front 16

What is the max contribution for an HSA for single and for mfj

Back 16

$3250 and $6450