Social Insurance Overview

Study Notes

Medicare: A federal program offering health insurance.
- Part A: Covers inpatient care, skilled nursing, hospice, and some home health care.
- Part B: Covers outpatient care, doctor services, and preventive services.
- Part C (Medicare Advantage): Private insurance options offering additional benefits.
- Part D: Prescription drug coverage.
Medicaid: A joint federal and state program providing health coverage to low-income individuals and families.
Social Security: A federal program providing retirement, disability, survivor, and dependent benefits, funded by payroll taxes.

Other Insurance Concepts

Disability:
- Total Disability: Inability to work in any occupation.
- Partial Disability: Limited ability to work or perform some duties.
- Recurrent Disability: Disability recurring after recovery.
- Residual Disability: Loss of income following a disability, even after returning to work.
Policy Ownership: Policyowners have rights such as naming beneficiaries, borrowing against cash value, and modifying policy terms.
Dependent Children Benefits: Coverage for dependent children contingent on age or stipulations.
Beneficiaries:
- Primary Beneficiary: First recipient of benefits.
- Contingent Beneficiary: Receives benefits if the primary beneficiary isn't available.
Premium Payment Modes: Options for paying premiums (monthly, quarterly, semi-annually, annually).
Benefit Coordination: Prevents duplication of benefits from multiple policies, establishing coverage priority.
Coverage Types:
- Occupational: Covers work-related injuries.
- Non-Occupational: Covers injuries unrelated to work.
Taxation: Rules regarding taxability of premiums, benefits, and payouts (e.g., employer-paid disability income is often taxable).
Managed Care: Health insurance systems focusing on cost control and coordinated care (HMOs, PPOs).
Workers' Compensation: Mandatory insurance covering work-related injury/illness expenses and lost wages.
Subrogation: Insurer's right to recover costs from a liable third party after a claim is paid.

Description

This quiz covers the essential aspects of social insurance programs like Medicare and Medicaid, along with Social Security benefits. You'll explore different parts of Medicare, the distinctions in disability types, and how these programs assist various populations. Test your knowledge on these important insurance concepts.