Health insurance plans
*deductibles
)Money paid by patient , before insurance payments
-kick in- some services may be exempt from deductibles,such as yearly physicals
*co- pay/insurance- expenses are shared by the patient and insurance company
-office visits
-pharmacy
*Group insurances
-premiums are paid at least partially by employer
HMO-Health maintenance org
- Emphasis:preventive care
- early treatment, health screenings,vision screenings - Theory:many plans don’t cover routine exams, therefore being skipped by patients, the patient would stay healthier and reduce health care costs in the long run, if probs were diagnosed earlier
*Disatvanage- can only go to facilities that they have contracts with.
- payments:
- fees stays the same regardless of how many patients they see
- (capitation)- per member/ per month
- based on previous made agreement
PPO-proffered provider org
- supplied by large companies or industries (GE)
- more popular than HMO’s
- Don’t hire physicians, rather health acre facilities
- provide more options
EPO-Exclusive Provider Org.
- least popular
- charges fees to access network of providers
- claims to do this to keep costs down and prevent Frivolous use
Medicare(title 18)
- Services for people 65 years and older
- amendment of the constitution:entitlement program-can never be undone
Workers company
- for the treatment for injuries at work
- admin. by state
- paid by state and employer
- also pays for wages lost because on the job injury
Managed care
Focus:to reduce health care have a purpose
- comp. managing costs
Medicaid
-gov. Insurance for people who need gov. Assistance
Government
-tricare veterans administration,- health insurance for veterans
