Exam 2 Review Flashcards
What is Medicare?
A federally funded health insurance program for individuals over 65, disabled for two or more years, or with specific conditions like kidney failure or ALS.
What percentage of costs do Medicare patients typically pay?
20%
What services are covered under Part A of Medicare?
- Emergency room
- Hospital care
- Inpatient care
- Physical Therapy (PT)
- Occupational Therapy (OT)
- Speech-Language Pathology (SLP)
- Wound care (skilled nursing)
- Home care
- Hospice
What services are covered under Part B of Medicare?
- Doctor visits
- Durable medical equipment
- Outpatient services
- Mental health services
- Preventative care
- X-rays and lab tests
- Some home health services
- Ambulance services
What is Part C of Medicare also known as?
Medicare Advantage
What does Part C of Medicare provide?
A combination of Part A and Part B services provided by private insurance, often including vision and dental coverage.
What is the purpose of Part D of Medicare?
To provide prescription drug coverage through private companies contracted with the government.
What is Medicaid?
A federally and state funded program providing health coverage for low-income individuals, children, and those with disabilities.
What services does Medicaid cover?
- Inpatient and outpatient services
- Radiological services
- Home health
- Vaccines
- Family planning and pregnancy
What are the main differences between HMOs and PPOs?
- HMO: Lower payments, in-network providers, requires referrals
- PPO: More flexibility in choosing care, higher costs for out-of-network services
What is TRICARE?
A Department of Defense health care program for uniformed services members, retirees, and their families.
What is the role of the Indian Health Services?
Provides healthcare to Native Americans and Alaska Natives.
What does the acronym WIC stand for?
Women, Infants, and Children
What are the two main components of the US healthcare system?
- Private or personal care
- Public health
What demographic trends are currently affecting healthcare?
- Population growth
- Aging baby boomer generation
- Changes in minority groups
- Changing household composition
- Declining mortality rates
What is a key challenge in the US healthcare system?
Not enough primary care providers