Test on Tuesday
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| a plan that helps the consumer pay for medical cost | Health Insurance Plan
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| an illness already present when applying for a new insurance plan | pre-existing condition
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| law that states all individual in a given population must be insured | guraranteed issue
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| Medicare pays a set amount for specific classifications of diagnoses regardless of actual cost | DRG's (Diagnostic Related Groups)
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| Laws limiting medical malpractice suit payments | Tort Reform
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| employee can pay to keep group health insurance for 18-36 months after leaving a job or losing health insurance and prevents "lapse in coverage" situation which prevents issues with per-existing conditions | COBRA (consolidated Omnibus Budget Reconciliation Act) ~1986~
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| amount you pay to belong to a health plan | premium
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| amount you must pay each year before health plan begins paying | deductible
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| % of medical costs a person must pay after meeting deductible | Co-insurance
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| set fee paid each time person receives medical care | Co-pay
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| employer offers plan to workers, share cost of premiums | Group insurance
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| purchase plan directly from insurance company, pay own premiums | individual insurance
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| can choose provider, deductible and co-insurance must file an insurance claim for each service | Indemnity insurance
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| a "network" of providers on the plan, cost lower if use network providers, no insurance claim forms, co-pays | Managed care plan
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| receive most of care from primary care doctor, specialists require a referral, will only pay for network providers, pays for routine and preventative care | HMO (Health maintenance Organizations)
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| No referrals for specialists, can use network or non-network providers, pay more for non-network | PPO (Preferred Provider Organization)
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| federal, health coverage for age 65 and older and certain disabilities Plan A:hospital coverage/no premium, Plan B: Physician coverage/premium/optional | Medicare
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| Federal, administered by states, covers those with low income and disabled, eligibility and benefits vary by state | Medicaid
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| State medical coverage for low income children who do not qualify for medicaid | SCHIP/CHIP (State Children's Health Insurance Program)
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| Covers medical care for on the job injuries, covers part of wages lost due to injury, cost shared by state and employer | Worker's Compensation
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| Federal medical plan for active duty and retired military personnel, their dependents, and survivors | CHAMPUS (Civilian Health and Medical Program US)
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| federal law requires that hospital emergency departments treat emergency condition of all patients regardless of their ability to pay | EMTALA
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| state-based brokerages (agencies) where uninsured us citizens, legal immigrants, and small businesses can purchase insurance | health insurance exchanges
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| a minimum income level below which a person is officially considered to lack adequate subsistence and to be living in poverty | federal poverty income (FPI)
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| monetary assistance granted by the government to an individual or group in support of a project regarded as being for the public good | subsidy
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| money made on investments, alimony, child support, etc. -you did not have to earn or work for it | unearned income
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| expensive employer paid health plans valued at 10,200 per employee or 27,500 for their family | Cadillac plans
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| pre-tax savings accounts from which you can pay for health care expenses | flexible spending accounts (fsa)
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| can carry over unused money year to year | HSA
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| estimate carefully use it or lose it end of year | HRA
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| an attempt to find a solution to the high cost of health care and to improve access to care for those who can least afford it | patient protection and affordable care act
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| an attempt to create balance to make health care equally accessible and equally affordable to all citizens | Reconciliation
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| by 130 billion over 10 years further reduce the deficit by 1.2 trillion in the second 10 years | reduce federal deficit
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| affordability individual responsibility employer responsibility defining income subsidies and implementation of funding | primary focus will be on
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