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16 Cards in this Set

  • Front
  • Back
What are the the three major types of managed care plans
Health maintenance organization, PPO, preferred provider and point of service plans. All managed care plans provide a primary care physician or gatekeeper
What is a health reimbursement arrangements?
Employees are reimbursed for medical expenses by employer
What are the qualifying events under COBRA?
18 months=terminated employees or conv to part tieme
29 months= disabled
36 months=MDs; medicare eligibility; Death; Dependents;; Deletion of plan; Divorce
How long does an employee have to elect COBRA
60 days. Once elected, the employee or beneficiary has 45 days to pay the premium
Which employers must offer COBRA
All employers with 20 or more employees
What is HIPPA
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
What is Obamacare, PPACA
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.
What is Medicare
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
What is the breakpoint in a major medical policy?
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.
What is first-dollar coverage?
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.
Are health care premiums deductible?
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.
How does contributions to a health savings account appear on tax return
Above the line deduction
Is there a premium for Medicare part A
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.
What is not covered under Medicare Part B
routine immunizations, cosmetic surgerys unless needed due to an accident, dental care, eyeglasses, hearing aids, orthopedic shoes and routine foot care.
Name some types of medical insurance
physicians, surgical, and hospital
What is the max contribution for an HSA for single and for mfj
$3250 and $6450