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Chapter 14. Health, Disability, & Life Insurance. What is Health Insurance?. Form of protection that eases the financial burden people may experience as a result of illness or injury Coinsurance - percentage of medical expenses the policyholder must pay in addition to the deductible amount
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Chapter 14 Health, Disability, & Life Insurance
What is Health Insurance? • Form of protection that eases the financial burden people may experience as a result of illness or injury • Coinsurance- percentage of medical expenses the policyholder must pay in addition to the deductible amount • Stop-loss provision- requires policyholder to pay all costs up to a certain amount, after which the insurance company pays 100% of the remaining expenses covered in the policy
Co-payment • Flat fee that you pay every time you receive a covered service • Managed care- prepaid health plans that provide comprehensive health care to their members • Blue cross/Blue Shield- statewide organizations that provide hospital care benefits as well as surgical & medical services performed by physicians.
Health Maintenance Organizations (HMO) • Health insurance plan that directly employs or contracts with selected or preapproved physicians to provide health care services in exchange for a fixed, prepaid monthly premium • Preferred provider organization (PPO)- group of doctors & hospitals that agree to provide specified medical services to members at prearranged fees • Point-of-service (POS) plan- combined features of HMO’s & PPO’s
Medicare • Federally funded health insurance program available to people over 65 and to people with certain disabilities • Two parts • Hospital insurance • Medical insurance • Medicaid- medical insurance program offered to certain low-income individuals & families.
Disability income insurance • Provides regular cash income when an employee is unable to work due to pregnancy, a non-work-related accident, or an illness • Life insurance • Beneficiary- person named to receive the benefits from an insurance policy • Types: • Term • Whole life