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Chapter 2

Intro To Health Insurance

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)
Created by: devon.harbaugh