access and health insurance Flashcards
access means what?
access to insurance, access to care. insurance is a good marker for access, since usually coorelated
insurance benefit
services covered
insurance premium
monthly cost
copay
point of care cost
coninsrance
percent paid by individual
insurance networks
negotiate rates.
types of insurance networks
closed, in/out, tiered. all have pros/cons
characteristic of uninsured/underinsured
most work!
private insurance
individual pays premium, insurer reimburses provider, pt pays provider, usually sponsored by employer.
medicaid
entitlement based (low income), federal and state run, mandates and optional programs
CHIP is part but a block plan (runs out)
healthcare exchanges
ACA, tax credit for the poor, private plans, some states only one plan= monopoly, not that helpful, healthier risk pool
medicare
federal and private, taxes, general revenue, premiums, benefits in “parts” a-d. hospital, outpatient, advantage, prescriptions.
