Health industry today
Medicare-A government-funded program that is funded by federal taxes
What is Medicare's main target
For individuals over the age of 65 and covers people of any age who have a disability that prevents from from working (ex. kidney failure)
Medicaid-Insurance program for people with low incomes and few personal assets, the state determines who is eligible for the program by following federal guidelines
How is Medicaid paid for
By state and federal taxes
TRICARE-The Military Health System offers TRICARE an insurance plan offered to everyone (active duty, retirees, and their families)
Worker's Compensation- Form of Government insurance that provides wages replacement and medical benefits for employees injured while at work
Can you sue the employer even with WC-No, the injured employee gives up the right to sue the employer for negligence if he/she accepted WC
Affordable Care Act (ACA)-Passed in 2010. A long complex piece of legislature that aimed to increase the quality and affordability of health insurance
How long does ACA allow dependents to be covered by their parents' insurance policies-ACA allows dependents to be covered by their parents' insurance policies until age 26
Managed care-General term for any healthcare plan that emphasizes wellness and provides healthcare through a network of doctors, hospitals, and other healthcare providers
What are the common forms of private medical insurance-Health Maintenance Organization (HMO) and Preferred Provider Organizations (PPO)
Health Maintenance Organization (HMO)-(Copayment) Managed care organization that provides prepaid, comprehensive healthcare at a FLAT rate and for a fixed period of time through a network of participating healthcare professionals and hospitals
What do Policy holders select during a HMO-Policy holders select a primary care physician (PCP) and referrals from PCP must be obtained to see a specialist
Preferred Provider Organizations (PPO)-(Deductive) health insurance organizations that contract with a network of preferred providers from which the policy holder can choose.
What do PPOs include-Involves an annual deductible payment for service, but patients do not have a designated PCP and may self-refer to specialists. They require an annual deductible payment for services-the cost you pay out of pocket before your insurance company begins covering your expenses-
Deductible-The amount you pay before insurance covers cost
High deductible equals…-Low premium/monthly bill
Low deductible equals…-High premium/monthly bill
The United States Public Health Service (USPHS)-Federal agency. Aims to promote public health. State and local public health departments provide services to communities : reporting diseases, public nursing, maternal and child health services, running public clinics
Occupational Safety and Health Administration (OSHA)-Imposes safety and health legislation (to prevent injury, illness, and death) in the workplace
The Centers for Disease Control and Prevention (CDC)-Monitors and prevents disease outbreaks (develop disease prevention strategies), responds to environmental emergencies, health threats, provides research
The Food and Drug Administration (FDA)-Protects public health by setting standards for food production, also regulates the safety of human and veterinary drugs, vaccines, biological products, medical devices, and makeup products
The National Institutes of Health (NIH)-Conducts and supports medical research
The World Health Organization (WHO)-Directs and coordinates health-related matters (with the UN system). Provides leadership on global health issues, health research, sets standards, and provides required tech support, and monitors global health developments