DISCUSS THE BASIC PRINCIPLES OF DIFFERENT INSURANCE PLANS

Health Insurance Plans Deductibles Amounts that must be paid by the patient for medical services before the policy begins to pay Co-insurance Requires that specific percentages of expenses be shared by the patients and insurance company

Health Insurance Plans Co-payment A specific amount of money a patient pays for a particular service. Health Maintenance Organizations (HMO) A monthly fee or premium is paid for membership, and the fee stays the same regardless of the amount of health care used.

Health Insurance Plans Preferred Provider Organizations (PPO) Provided by large industries or companies to their employees Employees are restricted to using the specific hospital and/or doctors

Health Insurance Plans Medicare - Federal government program that provides healthcare for almost all individuals over the age of 65 or anyone disabled Type A - Covers hospital services & care provided by an extended care facility or home health care agency after hospitalization Type B - Offers additional coverage for doctor’s services, outpatient treatments, therapy, and other health care

Health Insurance Plans Medicaid Medical assistance program run by the state Low incomes, children, disabled Worker’s Compensation Treatment for workers injured on the job Payments by the state and employer Plan pays worker for lost wages due to on the job injury.

Health Insurance Plans TRICARE US Government health insurance plan for all military personnel Managed Care All health care provided to a patient must have a purpose Second opinion Preventive care Tiered care

Summary Many different types of health care facilities Employ many types of health care workers Important to be aware of facilities and type of services Important to be aware of different insurance plans