 Indemnity or Fee-for-Service coverage- -allow you go to the doctor of your choice and pay for services at the time of the visit. -The amount that your.

Slides:



Advertisements
Similar presentations
What I need to know about health insurance.. Introduction to Health Insurance Basics Terms Scenario Mandated covered services Plans Identify Explain Pros.
Advertisements

Insurance.  Many people in the US are uninsured – assume all responsibility for health care costs.  Insurance decreases out of pocket expenses for health.
What is Health Insurance? Health insurance is a contract between a consumer and an insurance company. Health coverage helps people pay for medical costs.
PAYMENT METHODS: Managed Care and Indemnity Plans
Medicare Supplement vs Medicare Advantage For authorized agent use only. Not for public use.
Types of Health Plans. The practice of medicine is complicated and expensive Medical insurance often covers routine care, such as annual physicals, and.
© 2009 Corporate Executive Board, All Rights Reserved. Health Plan Dictionary How to Understand Your Plan and Make Cost- Effective Choices.
1 Introduction to the Medical Billing Cycle Chapter One lecture 2 OT 232.
1.03 Healthcare Finances Understand healthcare agencies, finances, and trends Healthcare Finances Government Finances Private Finances 2.
Click here to advance to the next slide.. Chapter 35 Life and Health Insurance Section 35.2 Health Insurance.
Understanding Your Options Sarah Hartshorn Rob Bachman Jeff Jensen An Introduction to Health Insurance.
+ HEALTH INSURANCE TERMS TO KNOW. + Premiums A premium is a fixed dollar amount that will stay the same each month whether you use the doctor a lot or.
Health Care. HMO: Health Maintenance Organization Group insurance that entitles members to services at participating hospitals. – Traditionally lower.
Healthcare Finances HS II Unit 1.03.
Y0096_MRK_IL_MAEDPPT15. Today’s Topics Medicare Basics Medicare Advantage (MA) Plans Eligibility and Enrollment periods 2.

Health Insurance Law and You Mr. Blais. Managed Care Plans These involve arrangements between the insurance companies and a certain network of health-care.
Section 24.2 Participating in Your Healthcare Slide 1 of 18 Objectives Describe how to choose and participate fully in your healthcare. Compare different.
Risk Management & Insurance Basics Automobile InsuranceHealth Insurance Life Insurance Property & Liability Insurance
Health Insurance HEALTH INSURANCE COVERAGE Hospital insurance pays for most of your charges if you are hospitalized with and illness or injury.
1.3 Health Care Plans (Continued) 1-14 Managed care offers a more restricted choice of providers and treatments in exchange for lower premiums, deductibles,
Insurance Terms and Concepts Medical Insurance involves a contract in which a business agrees to pay a portion of a patient’s medical expenses in exchange.
Medical Insurance. Overview  Many people in the US are uninsured – they assume all responsibility for health care costs.  The number of uninsured is.
Caleb Modzelewski 4 th Period.  Preferred Provider Org. Plan (PPO) - A PPO combine elements of indemnity and managed care plans. Each time you need care,
Triple Choice Enrollment THE BASICS DEFINITIONS HMO (Health Maintenance Organization): A form of health insurance combining a range of coverage.
What is it? An organization of physicians or other health care professionals that provides a broad and nearly complete range of health care services on.
U.S. Healthcare Policy. Project 4: One page summary of the project including comments on the student's contributions. Describe how the project contributed.
There’s So Much More to Medicare, Let’s Talk Humana Medicare Advantage Health and Prescription Drug Plans M0006_GH210S6RR KC0906.
INSURANCE what you need to know. Car Insurance Deductible – How much you have to pay before the insurance company begins to payDeductible – How much you.
 Both fee-for-service and managed care cover medical,surgical, and hospital expenses  Can also cover prescription drugs and dental  Both pay premiums.
Paying for Health Care Insurance Medicare and Medicaid Managed Care Workers’ Compensation Military Health Care.
INSURANCE & COSTS HEALTH CARE SERVICES. MEDICAL CARE (INSURANCE) HEALTH MAINTANCE ORGANIZATION (HMO) – A TYPE OF GROUP HEALTH INSURANCE PLAN – MEDICAL.
Health Insurance Mr. Peterson.  st=PLAEF1F13C29ACCC01&index=1&feature=plpp_vide o
Managed Care Organizations. Managed Care Continuum Use of Managed Care Techniques Less More Traditional Indemnity Health Plan Traditional with Cost Containment.
Insurance.  Many people in the US are ________ – assume all responsibility for health care costs.  Insurance _______ out of pocket expenses for health.
Health Insurance Why the Need? Protects consumers from the high costs of medical bills due to illness or injury & against the law not to have it.
Chapter 22 Buying InsuranceSucceeding in the the World of Work 22.3 Health and Life Insurance SECTION OPENER / CLOSER INSERT BOOK COVER ART Section 22.3.
1 Chase Smith Health Insurance. 2 Health Insurance Facts 85 of 100 Americans are currently covered by a government based health insurance or private health.
Agribusiness Library LESSON: HEALTH INSURANCE. Objectives 1. Determine the function of health insurance, and define common health insurance terms. 2.
Insurance. Health Insurance  Many people in the US are uninsured – assume all responsibility for health care costs.  Insurance decreases out of pocket.
Comprehensive Health Insurance Billing, Coding, and Reimbursement Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights.
Health care costs continue to increase! 40% of US citizens are uninsured! Health Insurance 101 (Managed Care)
Insurance Lesson Hunter Cooley 4 th period. Types of insurance HMO (Health Maintenance organization) you must choose a primary care physician, frequently.
1.03 Healthcare Finances. Health Insurance Plans Premium-The periodic amount paid to an insurance company for healthcare or prescription drugs Deductible-Amount.
Peace of Mind Insurance can give you financial security and peace of mind, especially in case of unexpected expenses. When do people use insurance?
1.03 Healthcare Finances Understand healthcare agencies, finances, and trends Healthcare Finances Government Finances Private Finances 2.
Health Insurance Plans 2.4 Cost is a major concern Health care is over 15% of the gross national product Without insurance the cost of an illness can become.
Unit C: Health Care Systems Part 4 Health Team Relations.
WHAT IS AN HMO? SHBP Health Maintenance Organization.
Medical Insurance Copyright © Texas Education Agency, All rights reserved. 19.
HEALTH INSURANCE PLANS. BACKGROUND INFO Cost is a major concern Health care is over 15% of gross national product Without insurance, the cost of an illness.
PPO Plans What You Need To Know Burt Krebs Virginia State Insurance Manager.
“There are worse things in life than death. Have you ever spent an evening with an insurance salesman?” -Woody Allen Copyright © eNestEgg Press, LLC.
Health Insurance Anyone been to the doctor this year? Have they used the health plan in the past year that they know of?
11.1 H EALTH I NSURANCE P REMIUMS Protects you against overwhelming medical expenses. Many kinds. Three most popular: Traditional: Offers health care coverage.
MGT 4543: Compensation Management Chapter 10 Part II Employer-Sponsored Health Insurance Programs.
Health Insurance Chapter 9. Importance Of Health Insurance In 2007, 60% if all personal bankruptcies were due to medial costs.
Health Insurance Why do people get health insurance?
HEALTH INSURANCE PLANS
Managed Health Care Manar alramli
Personal Finance Health Insurance
Types of Health Plans.
Insurance.
Health Insurance in the USA
Health Insurance Premiums & Benefits
Methods of Payment for Healthcare
Health Insurance Premiums & Benefits
Health Care.
Health Care Objective:
Health Care Objective:
Presentation transcript:

 Indemnity or Fee-for-Service coverage- -allow you go to the doctor of your choice and pay for services at the time of the visit. -The amount that your health insurance company will pay is a predetermined benefit level of covered medical expenses, based on your deductible and co-insurance amounts. -To receive payment for medical expenses, you may have to fill out forms and send them to your insurer and are responsible for keeping track of all your medical expenses.  Health maintenance organizations (HMO)- - you pay a fixed monthly fee called a premium. -the health insurance company and its physician network provide a variety of medical benefits. -The primary care physician you choose from this network is responsible for your health care as well as for making referrals to specialists and approving further medical treatment. -Usually, your choice of doctors and hospitals is limited to those within the network since they have agreements with the HMO to provide your health care. - care received outside of the health care network is not covered.  Preferred provider organizations (PPO)- - operate like an HMO in that you pay a fixed monthly premium, and the health insurance company and its health care network provide medical benefits to you. -However, under a PPO insurance plan, a primary care physician is not required. As a result, seeing a specialist does not require a referral. -If you need or want health care from outside the network, you should expect to pay a higher co-payment or co-insurance than if the provider were from within the PPO network. - each time you need medical attention, you can decide between a higher costing plan with freedom of choice or a lower costing plan that restricts your care to within a network.