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Chapter 2
Intro To Health Insurance
Term | Definition |
---|---|
Preventive Services | Are designed to help individuals avoid health and injury problems |
Health Insurance | A contract between a policyholder and a third-party payer or government health program to reimburse the policyholder for all or a portion of the cost of medically necessary treatment or preventive care provided by the health care professional. |
Policyholder | Person who signs a contract with a health insurance company and who, thus owns the health insurance policy. |
Third-party payer | Health insurance company that provides coverage |
Group health insurance | Health insurance coverage subsidized by employers and other organizations |
Individual Health insurance | Private health insurance policy purchased by individuals or families who do not have access to group health insurance coverage. |
Public Health Insurance | Federal and state government health programs available to eligable individuals. |
Single payer system | Centralized health care system adopted by some Western nations and funded by taxes. The government pays for each residents health care, which is considered a basic social service. |
Socialized medicine | A type of single payer system in which the government owns and operates health care facilities and providers recieve salaries. |
Universal Health Insurance | The goal of providing every individual with access to health coverage, regardless of the system implemented to achieve that goal. |
Taft-Hartley Act | Restored a more balanced relationship between labor and management. |
Third-party administrators(TPAs) | Administer health care plands and process claims, thus serving as a system of checks and balances for labor and management. |
Deductible | The amount for which the patient is financially responsible before an insurance policy provides payment. |
Lifetime maximum amount | The maximum benefits payable to a health plan participant. |
OSHA | (Occupation Saftey Hazard Administration) Designed to protect all employees against injuries from occupational hazards in the workplace. |
HMOS | (Health Maintenance Organization Assistance Act) |