Health Insurance Plans Flashcards
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Questions and Answers

What is a Health Maintenance Organization (HMO)?

The purpose is to keep the patient healthy and is able to control costs by mandating generic usage.

What is a Preferred Provider Organization (PPO)?

A network of providers contracted by the insurer that offers the most flexibility to the patient.

What does Point of Sale (POS) refer to in insurance plans?

A network of providers under contract by the insurer.

What is Medicare?

<p>A federally funded program for individuals over the age of 65, disabled individuals younger than 65, and patients with kidney failure.</p> Signup and view all the answers

What is Medicaid?

<p>A federally funded program administered by the states.</p> Signup and view all the answers

What are Patient Assistance Programs?

<p>Special programs offered by pharmaceutical manufacturers for patients with specific needs.</p> Signup and view all the answers

What is Workman's Compensation?

<p>Federal and state laws require compensation for patients who have been accidentally injured.</p> Signup and view all the answers

Study Notes

Key Insurance Plans

  • Health Maintenance Organization (HMO): Aimed at preventive care and health maintenance, HMO plans control costs by promoting the use of generic medications among patients.

  • Preferred Provider Organization (PPO): Offers a flexible network of healthcare providers, allowing patients to choose their doctors and specialists without requiring referrals.

  • Point of Sale (POS): Operates as a hybrid between HMO and PPO, where patients can choose between using in-network providers or opting for out-of-network care, typically at a higher cost.

Government Healthcare Programs

  • Medicare: A federal health insurance program primarily designed for individuals aged 65 and older, it also covers certain younger individuals with disabilities and those diagnosed with end-stage renal disease.

  • Medicaid: A joint federal and state program providing healthcare coverage to low-income individuals, with administration managed at the state level, ensuring accessibility based on local needs.

Additional Programs

  • Patient Assistance Programs: Initiatives from pharmaceutical companies aimed at supporting patients with specific conditions or financial challenges, providing access to necessary medications.

  • Worker's Compensation: Legally mandated systems at both federal and state levels that ensure employees injured at work receive financial support for medical expenses and lost wages, protecting their rights as workers.

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Description

Test your knowledge of various health insurance plans with these flashcards. This quiz features terms like HMO, PPO, and POS, each accompanied by clear definitions. Perfect for students or professionals looking to deepen their understanding of health insurance options.

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