H OW DOES MY INSURANCE WORK ? Celebrate Wellness! A public service of The Unified Virginia Chiropractic Association in association with A Trusted Voice.

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Presentation transcript:

H OW DOES MY INSURANCE WORK ? Celebrate Wellness! A public service of The Unified Virginia Chiropractic Association in association with A Trusted Voice Presented by: Your Doctor of Chiropractic Underwritten in part by a generous donation from:

How Does My Insurance Work? Today’s Agenda: Health (sickness/injury) insurance: History Key Terms Facts & Tips Self-care and living WELL

How Does My Insurance Work? Today’s Agenda: Health (sickness/injury) insurance: History Key Terms Facts & Tips Self-care and living WELL

The Year: 1940

The Year: 1955

The Year: 1960

Part A: Hospital Insurance

Part B: Hospital Insurance

“Maintenance therapy is defined as a treatment plan that seeks to prevent disease, promote health, and Prolong and enhance the quality of life; or therapy that is performed to maintain or prevent deterioration of a chronic condition.” “Maintenance care [sometimes called “Wellness Care”] is not considered by Medicare to be medically reasonable and necessary, and is not reimbursable by Medicare.”

Part C: Medicare Advantage (?)

Part D: Rx Drug Coverage

1970’s, 1980’s, 1990’s… H.M. O. P.P.O. P.O.S.

The Year: 1996

The Year: 2010 The Affordable Care Act, AKA “Obamacare”

The Future

How Does My Insurance Work? Today’s Agenda: Health (sickness/injury) insurance: History Key Terms Facts & Tips Self-care and living WELL

Acute Subluxation (per Medicare Necessity for Treatment) Advance Beneficiary Notice (ABN) Affordable Care Act Allowable Charge Authorization Deductible Chronic Subluxation (as per Medicare Necessity for Treatment) Co-insurance Co-pay Covered Medical Expense Covered Services EOB Investigative Procedures or Medications Maintenance Therapy Medical Necessity Network Non-par (Non-Participating Provider) Par (Participating Provider) Pre-Authorization Pre-Certification Preventive Care Utilization Management Utilization review Wellness Program And more! Visit for a more comprehensive on-line “dictionary”

How Does My Insurance Work? Today’s Agenda: Health (sickness/injury) insurance: History Key Terms Facts & Tips Self-care and living WELL

Does health insurance guarantee good health?

How Does My Insurance Work? Today’s Agenda: Health (sickness/injury) insurance: History Key Terms Facts & Tips Self-care and living WELL

Celebrate WELLNESS!

Case Studies

Resources Unified Virginia Chiropractic Association Or just ask the doctor today!

Q UESTIONS ?