| Cost Sharing | stop-loss | Premiums and Deductibles | Private Insurance Definitions | Miscellaneous |
|---|---|---|---|---|
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Cost-sharing occurs when patients pay for a portion of health care costs not covered by health insurance.
What is cost-sharing?
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Out of a pocket maximum
What is stop-loss?
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The amount you pay for insurance policies monthly
What is a premium?
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What is group-insurance?
A type of health insurance and which all those insured have the same coverage and pay a set premium. A large number of people will buy insurance through a sponsor.
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How does a person qualify for Medicare?
65 years or older, have certain disabilities and end stage renal disease.
|
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To reduce the misuse of insurance benefits.
What is the purpose of cost-sharing?
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The insurance pays $10,000
If your stop-loss is $5,000 and your bill is $15,000, how much does the insurance pay?
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The amount you pay before your insurance benefits kick in, which you pay annually.
What is deductible?
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What is self-insurance?
Large employers pay health expenses to employees, the company does not use a health insurance company.
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who qualifies for Medicaid?
Families with very low income, disabilities etc
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Trick question all of them are ways to cost-share
Which of these are not a way of cost-sharing? Premium, deductible, co-pay, co-insurance, stop loss.
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You pay 10,000
if your bill is 20,00 and your insurance pays half how much do you pay?
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Premium is $400 and Deductible is $1,500
Barbra pays $1,500 before her insurance kicks in for the year and $400 every month. What is Barbra's premium? What is her Deductible?
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What is direct-purchase?
Purchased by an individual from an insurance company and is based on the premium on health status.
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What is another name for the Affordable Care Act?
Obama Care
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Co-payment - set dollar amount
Co-insuance - percentage
Between co-payment and co-insurance which one is a percentage and which one is a set dollar amount?
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Your insurance pays 5,000
If your bill is 15,000 and you have an out of pocket maximum of 10,000 how much does your insurance pay?
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The premium is $7,200 and the deductible is $2,000.
Nancy pays $600 every month and before her insurance comes in she has to pay $2,000. What are the premiums and the deductible for the whole year?
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What is the managed care plans?
MCO's overseeing everything, middleman making deals through discounts or capitation, manages health care
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What does CHIP stand for and who does it cover?
Children's Health Insurance Program
Children up to 19 can qualify if they exceed Medicaid threshold levels |
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He pays $75 and this is called co-pay.
Johnny visits the doctor 5 times and for one visit is $15, how much does he pay for 5 visits? What would this be called?
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High-Deductible health plans (HDHP)
low premium costs,savings account
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What are the different parts of Medicare
Part A Hospital Insurance
Part B Supplementary Medical Insurance Part C Medicare Advantage Part D Prescription Drug Coverage |
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