Healthcare Basics Flashcards
Health Insurance
Health insurance provides coverage for medication, doctor and emergency room visits, hospital stays, medical equipment, and other medical expenses.
Medicare
The two main publicly funded health care programs are Medicare, which provides health services to people over 65 years old as well as people who meet other standards for disability, and Medicaid, which provides services to people with very low incomes who meet other eligibility requirements.
Medicaid
The two main publicly funded health care programs are Medicare, which provides health services to people over 65 years old as well as people who meet other standards for disability, and Medicaid, which provides services to people with very low incomes who meet other eligibility requirements.
In-Network Providers
In-Network Providers: health care providers who are contracted with your health insurance plan to provide services at a contracted or discounted rate.
Out-of-Network Providers
Out-of-Network Providers: health care providers who are not contracted with your health insurance plan. Out-of-network coinsurance usually costs you more than in-network coinsurance because there is no contracted or discounted rate.
Premium
Premium: The amount paid for your health insurance every month. In addition to your premium, you usually have to pay other costs for your health care, including a deductible, copayments, and coinsurance.
Deductible
Deductible: The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.
Copayment
Copayment: A fixed amount ($20, for example) you pay for a covered health care service after you’ve paid your deductible.
Coinsurance
Coinsurance: The percentage of costs of covered health care service you pay (20%, for example) after you’ve paid your deductible.
Out-of-Pocket Maximum
Out-of-pocket maximum: The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits.
Scope of Practice
Scope of practice is defined as services that a trained health professional is deemed competent to perform and permitted to undertake according to the terms of their professional license. Scope of practice provides a framework and structured guidance for activities one can perform based on their license.
Primary Care
Primary care promotes wellness and prevents disease.
Secondary Care
Secondary care occurs when a person has contracted an illness or injury and requires medical care.
Tertiary Care
Tertiary care addresses the long-term effects from chronic illnesses or conditions with the purpose to restore a patient’s maximum physical and mental function.
Negligence
Negligence is conduct that is careless or doesn’t provide the standard of care that a reasonable person would use.
