INSURANCE & COSTS

HEALTH CARESERVICES

MEDICAL CARE(INSURANCE)

HEALTH MAINTANCE ORGANIZATION (HMO)– A TYPE OF GROUP HEALTH INSURANCE PLAN– MEDICAL NEEDS MET THROUGH A SET OF

DESIGNATED DOCTORS – ‘PRIMARY CARE PHYSICIAN’– MONTHLY PREMIUM / FEW OR NO OUT-OF-

POCKET EXPENSES

MEDICAL CARE(INSURANCE)

PREFERRED PROVIDER ORGANIZATION (PPO)– A TYPE OF HEALTH INSURANCE PLAN– DESIGNED BY INSURANCE COMPANIES– MEDICAL NEEDS MET THROUGH ANY DOCTOR AVAILABLE– CHARGE PEOPLE LESS THAN USUAL FEES FOR DOCTORS

WITHIN THE PROGRAM– CAN CHOOSE DOCTOR OUTSIDE OF PLAN – COSTS MORE– MONTHLY PREMIUM / CAN CHOOSE DOCTOR IN PLAN OR

ONE OUTSIDE OF PLAN

MEDICAL CARE(TERMS)

PRIMARY CARE PHYSICIAN– MEDICAL DOCTOR WHO PROVIDES PHYSICAL

AND CHECKUPS / GENERAL CARE

SPECIALISTS– MEDICAL DOCTORS TRAINED TO HANDLE

PARTICULAR KINDS OF PATIENTS OR MEDICAL CONDITIONS

MEDICAL CARE(INSURANCE)

MEDICAID– PUBLIC HEALTH INSURANCE THAT PAYS FOR

HEALTH CARE FOR PEOPLE ON WELFARE– PREMIUMS PAID FOR BY THE GOVERNMENT

ONLY– 30 BILLION PER YEAR

MEDICAL CARE(INSURANCE)

MEDICARE– PUBLIC HEALTH INSURANCE FOR PEOPLE 65 OR

OLDER AND THOSE WHO RECEIVE SOCIAL SECURITY

– VOLUNTARY ENROLLMENT– PREMIUMS SHARED EQUALLY BY PEOPLE AND

GOVERNMENT– 45 BILLION PER YEAR

MEDICAL CARE(INSURANCE)

MAJOR MEDICAL– DESIGNED TO GIVE LARGE AMOUNTS FOR MAJOR

EXPENSES– NOT SMALL OUT OF POCKET EXPENSES

COMPREHENSIVE– BASIC MEDICAL CARE PLUS MAJOR MEDICAL

COVERAGE INCOME (DISABILITY)

– BENEFITS WHEN ACCIDENTS OR SERIOUS ILLNESS OCCURS

MEDICAL CARE(SERVICES)

COSTS– ON AVERAGE OVER 125% MORE THAN 10 YEARS

AGO– REASONS:

CONSTRUCTION COSTS HOSPITAL EMPLOYEE SALARIES EQUIPMENT BECOMES OBSOLETE & UNUSUABLE MALPRACTICE INSURANCE

MEDICAL CARE(SERVICES)

FACILITIES– PRIVATE PRACTICES– CLINICS– GROUP PRACTICES– HOSPITALS– EMERGENCY ROOMS– URGENT CARE CENTERS