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insurance
| Question | Answer |
|---|---|
| Health insurance | A plan that helps pay for medical expenses |
| PPO (Preferred Provider Organization) | A health insurance plan that allows patients to see in-network or out-of-network providers without a referral |
| HMO (Health Maintenance Organization) | Requires patients to choose a primary care provider (PCP) and usually requires referrals to see specialists |
| POS (Point of Service) | Combines features of HMO and PPO; requires a PCP but allows some out-of-network care |
| EPO (Exclusive Provider Organization) | No referrals required, but generally covers only in-network providers except in emergencies |
| Medicare | Federal health insurance for people age 65 and older and certain younger people with disabilities |
| Medicaid | State and federal health insurance for eligible low-income individuals and families |
| Copayment (Copay) | A fixed amount the patient pays for a healthcare service |
| Deductible | Amount the patient pays before insurance begins paying |
| Coinsurance | Percentage of costs the patient pays after meeting the deductible |
| Premium | Monthly amount paid to keep insurance coverage active |
| Explanation of Benefits (EOB) | Statement explaining what insurance paid and what the patient may owe |
| Preauthorization (Prior Authorization) | Approval required from insurance before certain services or procedures |
Created by:
Valentine.Taylor