front 1 Affordable Care Act | back 1 Federal Act that made healthcare more affordable Provided more healthcare to those with well below the poverty level Mandated that all individuals needed insurance |
front 2 Types of Private Insurance | back 2 Insurance an individual can sign up for and pay for on their own or as a benefit of employment. Blue Cross Harvard Pilgrim Fallon Health |
front 3 Public Health Insurance | back 3 Insurance that is paid for or subsidized by Federal and/or State governments. Ex. medicare and medicaidPoint of Service |
front 4 Premium | back 4 the monthly fee for your health insurance Fees vary for individual, family or couple plans |
front 5 3 Factors that Insurance premiums are based off of | back 5 age location smoking habits |
front 6 deductible | back 6 the amount the insured must pay before insurance kicks in to cover costs |
front 7 Co-inurance | back 7 the percentage of cost that the insured must pay for services |
front 8 Out of Pocket Maximum | back 8 The total amount insured would have to pay in a year before the insurance will pay for everything else. |
front 9 Actuarial Value | back 9 The percentage of costs that the insurance plan pay for for medical expences |
front 10 Metals | back 10 the varying types of levels within an insurance company Fees for premium and co-insurance vary Platinum is most expensive premium with lowest co-insurance Bronze has cheapest premium but higher co-insurance and deductibles |
front 11 Catastrophic Plan | back 11 insurance plan for individuals that are under 30 Very low premium, high deductible For mostly emergencies, some cover preventative care |
front 12 HMO | back 12 Health Maintenance Organization' Must have Primary Care Physician Must see in-network doctors Need referrals for specialists |
front 13 EPO | back 13 Exclusive Provider Organization Hybrid between HMO and PPO Can see out of network doctors without referral but will have to pay own expenses |
front 14 PPO | back 14 Preferred Provider Network Do not need primary care or referrals to see specialist Can see out of network doctors and only have to pay a portion of the expense |
front 15 POS | back 15 Point of Service Need a Primary Care Need referral but can see doctors outside of network and insurance will pay some of the fees |
front 16 Medicare | back 16 Public Insurance paid for by Federal Government For individuals 65 and over, or who have a disability or kidney failure Different types plans A, B, etc cover different expenses |
front 17 Medicaid | back 17 insurance that is funded by Federal and state funds State has say on coverage Covers low income, children, disabled and blind |
front 18 CHIP | back 18 Children's Health Insurance Program Covers children whose parents do not make enough to afford private insurance but are not eligible for medicaid. |
front 19 Veteran's Health Benefits | back 19 For veteran's that have medical conditions related to their time of service |
front 20 Tricare | back 20 Federal insurance for all active and retired military and their families |
front 21 Worker's Compensation | back 21 Insurance for those who are injured on the job Covered by state and employer Pays for lost wages and medical expenses due to injury on the job |