1. DISCUSS THE BASIC PRINCIPLES OF DIFFERENT INSURANCE PLANS

2. Health Insurance Plans
Deductibles
Amounts that must be paid by the patient for medical services before the policy begins to pay
Co-insurance
Requires that specific percentages of expenses be shared by the patients and insurance company

3. Health Insurance Plans
Co-payment
A specific amount of money a patient pays for a particular service.
Health Maintenance Organizations (HMO)
A monthly fee or premium is paid for membership, and the fee stays the same regardless of the amount of health care used.

4. Health Insurance Plans
Preferred Provider Organizations (PPO)
Provided by large industries or companies to their employees
Employees are restricted to using the specific hospital and/or doctors

5. Health Insurance Plans
Medicare - Federal government program that provides healthcare for almost all individuals over the age of 65 or anyone disabled
Type A - Covers hospital services & care provided by an extended care facility or home health care agency after hospitalization
Type B - Offers additional coverage for doctor’s services, outpatient treatments, therapy, and other health care

6. Health Insurance Plans
Medicaid
Medical assistance program run by the state
Low incomes, children, disabled
Worker’s Compensation
Treatment for workers injured on the job
Payments by the state and employer
Plan pays worker for lost wages due to on the job injury.

7. Health Insurance Plans
TRICARE
US Government health insurance plan for all military personnel
Managed Care
All health care provided to a patient must have a purpose
Second opinion
Preventive care
Tiered care

8. Summary Many different types of health care facilities
Employ many types of health care workers
Important to be aware of facilities and type of services
Important to be aware of different insurance plans