Health, Disability, & Life Insurance

Chapter 14

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 parts1. Hospital insurance2. 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