Health Insurance Flashcards
The four metals (from weakest to strongest)
Bronze, Silver, Gold, Platinum
What is the HMO?
Health Maintenance Organization. One of the major plans. You have to get a referral from a primary care physician. This plan is restrictive but has a lower premium. You get basic emergency care. Does not cover out of network.
What does out-of-pocket maximum mean?
The most amount of money you will pay.
What is the PPO?
Preferred Provider Organization. Any provider with no referrals. Things out of network are more expensive. Higher cost than EPO and HMO. Covers emergency care.
What does the word deductible mean?
The amount you pay for covered health care services before your insurance plan starts to pay
How much do you pay for a gold plan?
20%
Actuarial Value
The average percentage the insurance company pays per year.
What is the catastrophic plan?
A plan that covers major illnesses. However, it doesn’t cover many routine expenses.
What is coinsurance?
Coinsurance is the amount you pay for covered health care after you meet your deductible.
How much do you pay for a bronze plan?
40%
How much do you pay for a silver plan?
30%
What is the POS?
Point-of-service plans. Covers out of network. Need referrals from primary care physicians. Costs more than the HMO but less than the PPO. Covers emergency plans.
What does the word premium mean?
The amount of money you pay for your health insurance every month.
What is the EPO?
Exclusive Provider Network. Doesn’t need a referral as long as they’re in the same network. Does not cover out of network. Lower premium. Covers emergency care.
How much do you pay for a platinum plan?
10%
