Final Review Flashcards
Began as program for people ages 65 years and older
Expanded to include disabled individuals
Medicare Eligibility
- Covers hospital/inpatient care, skilled nursing care, and home healthcare after a hospitalization
- Primarily paid for by the payroll tax; no premium is required
- An annual deductible is required before receiving payments
Medicare Part A
- Voluntary supplementary insurance
- Covers a wide range of diagnostic and therapeutic services
- 75% is covered is funded by tax revenue, 25% by a monthly premium * The premium starts at more than $100/month
- Higher income members pay higher premiums
- Copayment = 20% for most services
Medigap policies are offered by private insurance companies to cover the 20% copayment
Medicare Part B
Special program designed to encourage Medicare beneficiaries to enroll in prepaid health plans
Medicare Part C
- Provides prescription (Rx) drug coverage
- Complicated plan available to those enrolled in Part A and Part B
- Monthly premium and an annual deductible
- Once an individual pays $5,000, Medicare pays for 95% of the additional costs of drugs
Medicare Part D
Designed to pay for health services for specific designated
groups: disabled individuals, children, pregnant women, etc.
For individuals, families, and children with limited income and resources
Medicaid Eligibility
Definition: Initial testing of drug on humans; may include health volunteers or terminally ill patients but not necessarily those on whom the drug will be used
Objectives: Assess pharmacology, including metabolism and excretion; establish dosage, timing, and route of transmission. Safety assessed especially on vulnerable organs e.g., liver, kidney, testicles, and bone marrow
Limitations: Small numbers of participants and short- term studies mean many effects may be missed
May not predict side effects when patients are not representative of those the drug will be given to in practice
FDA Phase 1
Definition: Initial small-scale, controlled or uncontrolled, trial of efficacy with secondary assessment of safety
Objectives: Establish that there is enough evidence of efficacy to warrant
Limitations: Primary intent is often “proof of concept”
FDA Phase 2
FDA Phase 3
FDA Phase 4
non-prescription drugs
FDA Implications
FDA Uses by clinicians
United States healthcare payer system used
Physician compensation types and most common used in the US
Insurance Terms
Premium
Deductible
Medicare Types (Parts) and what they cover
Environmental Health Assessments, Approach’s and examples of each
Examples of environmental exposures
altered environments
bioterrorism
