Chap 9 Flashcards
Hospital expense insurance, surgical expense insurance, and physician expense insurance
Basic health coverage
Pays part or all of hospital bills for room, board, and other charges.
Hospital expense insurance
An amount the insured must pay before benefits become payable by the insurance company
Deductible
Pays part or all of the surgeons fees for an operation
Surgical expense insurance
Provides benefits for doctors fees for nonsurgical care, x-rays,and lab test
Physician expense insurance
A provision under which both the insured and the insurer share the covered losses
Coinsurance
A provision under which an insured pays a certain amount, after which the insurance company pays 100 percent of the remaining covered expenses
Stop loss
Provides day in, day out care for long-term illness or disability
Long term care insurance
A provision under which the insured pays a flat dollar amount each time a covered medical service is received after the deductible has been met.
Copayment
An independent membership corporation that provides protection against the cost of hospital care
Blue cross
An independent membership corporation that provides protection against the cost of surgical and medical care
Blue shield
Prepaid health plans that provide comprehensive health care to members
Managed health care
A health insurance plan that provides a wide range of health care services for a fixed,prepaid monthly premium
Health maintenance organization (HMO)
A group of doctors and hospitals that agree to provide health care at rates approved by the insurer
Preferred provider organization (PPO)
A network of selected contracted, participating providers; HMO-PPO hybrid or open-ended HMO
Point of service (POS)
