Health Insurance

Question 1

Medicare

Answer 1

People age 65 or older
People under age 65 with certain disabilities
People of all ages with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant)

Question 2

Medicare Part A

Answer 2

“hospital insurance”
health coverage for inpatient care in hospitals, including critical access hospitals, and skilled nursing facilities. don’t pay a premium for Part A because they or their spouse already paid for it through their payroll taxes while working.

Question 3

Medicare Part B

Answer 3

“medical insurance”
provides health coverage for doctors’ services and outpatient care. include some services of physical and occupational therapists and some home healthcare. pay a premium

Question 4

Medicare Part C

Answer 4

expands the options for how people receive their benefits. This is also known as supplemental or gap coverage.

Question 5

Medicare Part D

Answer 5

provides prescription drug coverage. can buy this coverage with a monthly premium from private insurance companies. help lower prescription drug costs and protect against higher prescription costs in the future.

Question 6

Medicaid

Answer 6

federally and locally funded healthcare service that provides healthcare coverage to certain categories of financially distressed individuals and families.

Question 7

Health Insurance Portability and Accountability Act (HIPPAA)

Answer 7

Protection against plans that limit coverage for preexisting conditions
Protection from discrimination against employees and dependents based on health status
Opportunities to enroll in a new plan under certain circumstances
The right to buy individual coverage if no group health plan is available

Question 8

Health Maintenance Organizations (HMOs)

Answer 8

require subscribers to pick one primary care physician (PCP) to visit for all medical needs. physician and specialist must be within the HMO network

Question 9

Preferred Provider Organizations (PPOs)

Answer 9

allow subscribers to visit any physician or specialist they choose without a referral from a PCP. Visiting doctors outside of the PPO network will cost more than in-network visits, but insurance will still cover a portion of the expenses.

Question 10

Exclusive Provider Organizations (EPOs)

Answer 10

subscribers can choose to see any physician or specialist in the network without a referral, but they can’t see doctors outside of the network except in an emergency. responsible for the entire cost of care if physician is outside of network.