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types of insurance
study guide
| Question | Answer |
|---|---|
| in 1965, president Lyndon B. Johnson approved | a Government managed insurance program named Medicare |
| Medicare is divided into two coverage components of | Part A and Part B AKA original medicare |
| individuals must be 65 years or older, or | 65 years or younger with long term disabilities, or suffer from end stage renal disease. |
| Both programs have gaps in coverage that may be covered by | supplemental insurance |
| medi-gap is a | supplemental insurance policy provided through private insurance plan with payments such as co-insurance, co pays and deductibles that supplement medicare. |
| There is an open enrollment for medicare plans each year from | October 15 to December 7 |
| Medicaid was | signed into law the same year, 1965, by president Johnson and is a State and Government managed insurance program that supplements Medicare if the individual meets specific requirements |
| medicaid requires healthcare services to | low income children, the elderly, blind, and those with disabilities. |
| the Health Maintenance Organization is | another type of insurance that plans typically have lower monthly premiums. HMO has specific features that distinguish it from traditional insurance programs. |
| The doctor and/or facility agrees to | give the insurance a discount to be provider of services |
| Preferred Provider Organization (PPO) | patients usually pay more out of pocket expenses. The benefit is that the patient can choose a physician from the insurance list of contracted providers or may use any specialty physician without primary care physician's referrals. |
| There are no requirements to | choose a specific primary care physician |
| PPOs tend to have higher monthly premiums in exchange for | the flexibility to use providers both in and out of network without a referral |
| worker's compensation | is a government required and government enforced medical covarge for workers injured on the job, paid for by the employer. the programs are managed by each state in accordance with the state's workers compensation laws. |
Created by:
Miller.Seriah
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