Insurance Flashcards
Premium
The monthly fee you or your employer pay for health insurance coverage whether you use it or not
Deductible
Amount you pay before insurance policy begins to pay
Co-insurance
The way insurance expenses are covered between individual and insurance company (80/20 or 60/40)
Co-Payment
Set amount paid by patients for services
Health Maintenance Organization
Required to use HMO providers for coverage
Preventative care
Insurance provides managed care
Preferred Provider Organization
Provides managed care
Must choose PPO providers to get best rate (80/20)
Out of network greater cost (60/40)
Medicare
Covers people over 65 or with disabilities
Federal
2 year waiting period
Covers 80% of services
Medicaid
State and federal
Assistance for low income
Disabled
Tricare
Us gov military
SCHIP
Covers children of families who make too much for Medicaid but not enough for private insurance
Beveridge Model
Healthcare is paid for and provided by the government through tax dollars
You may never get a medical bill
Low cost per capita, controlled prices
Brattain, New Zealand, Spain
Bismark Model
Uses a program close to insurance called “sickness funds” which are paid into by employees and employers through paycheck deductions
No one can make a profit and all prices are controlled by the gov
Germany, Japan, Switzerland, and France
National Health Insurance Model
Private sector insurance paid by the government in which people pay into
No need for marketing, no motives to deny claims, no profit= cheaper universal program
Canada, South Korea, Canada
