Insurance, the Healthcare Crisis, and the ACA
Download
1 / 52

Insurance, the Healthcare Crisis, and the ACA - PowerPoint PPT Presentation


  • 74 Views
  • Uploaded on

Insurance, the Healthcare Crisis, and the ACA. Question 1 - 10. What kind of insurance did Ms. Mueller have?. Answer 1 – 10. Cigna PPO. Question 1 - 20. What is the difference between a copay and coinsurance?. Answer 1 – 20. Copay = fee that is paid at the time of service

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Insurance, the Healthcare Crisis, and the ACA' - hope-combs


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

Question 1 10
Question 1 - 10

  • What kind of insurance did Ms. Mueller have?



Question 1 20
Question 1 - 20

  • What is the difference between a copay and coinsurance?


Answer 1 20
Answer 1 – 20

  • Copay = fee that is paid at the time of service

    • Must be paid no matter where you are in the deductible

  • Coinsurance = where the expenses are split between the patient and the insurance company after the deductible has been reacher


Question 1 30
Question 1 - 30

  • What is the difference between an HMO and a PPO?


Answer 1 30
Answer 1 – 30

  • HMO: an insurance plan where you are restricted to a set of doctors

    • You must have a referral to see a specialist

    • Important for doctors to be “in-network”

  • PPO: an insurance plan where you do not need a referral to see a specialist

    • Insurance pays SOME for “out of network” visits


Question 1 40
Question 1 - 40

  • Where are 3 places where you can receive health insurance?


Answer 1 40
Answer 1 – 40

  • Employer, private, government


Question 1 50
Question 1 - 50

  • Compare and contrast Medicare and Medicaid


Answer 1 50
Answer 1 – 50

  • Medicare and Medicaid are both government insurance plans.

  • Medicare = elderly (age 65 and up)

  • Medicaid = low-income


Question 2 10
Question 2 - 10

  • What is 20% of $650?



Question 2 20
Question 2 - 20

  • For this medical insurance, there are no copays or deductibles. There is an 80/20 coinsurance.

    • Drs office visit: $130

    • Prescription: $70

    • X-ray: $1300

  • How much would the patient pay?



Question 2 30
Question 2 - 30

  • A health plan excludes vision and dental. There is a $750 deductible and a 70/30 coinsurance.

    • Eye exam: $75

    • Knee Surgery: $5000

    • Drs. Visit: $130

  • How much would the patient pay?


Answer 2 30
Answer 2 – 30

  • 75 + 750 + 1314 = 2139


Question 2 40
Question 2 - 40

  • A vision plan includes an eye exam and a $15 copay for glasses. The health plan has a $500 deductible and 80/20 coinsurance

    • Eye appointment: $100

    • Glasses: $150

    • Physical: $50

    • Prescription: $35

  • How much will the patient pay?


Answer 2 40
Answer 2 – 40

  • $15 copay for glasses

  • $0 for eye appointment

  • $85 for medical bills

  • Total: $100 (did not meet deductible)


Question 2 50
Question 2 - 50

  • A health plan includes dental (2 cleanings/year) and general health, but not vision. There is a $1000 deductible and 80/20 coinsurance.

    • 2 teeth cleanings: $130 each

    • Chiropractor visits: $500

    • Prescription: $130

    • Drs office visits: $200

  • What will the patient pay?


Answer 2 50
Answer 2 – 50

  • $0 for dental visits

  • $830 (did not meet deductible)


Question 3 10
Question 3 - 10

  • What percentage of Americans are currently uninsured?



Question 3 20
Question 3 - 20

  • What are the two reasons a person may be uninsured?


Answer 3 20
Answer 3 – 20

  • Possible answers: Cannot afford insurance, employer insurance not offered, denial for pre-existing conditions


Question 3 30
Question 3 - 30

  • What is COBRA?


Answer 3 30
Answer 3 – 30

  • States that a person laid off from their job can still use their health plan for 18 months after becoming unemployed, but must pay the entire premium.


Question 3 40
Question 3 - 40

  • Why might a disabled person not have insurance?


Answer 3 40
Answer 3 – 40

  • Denial b/c of preexisting condition

  • Cost

    • Premiums inflated because of health status

    • Cannot work so cannot afford cost


Question 3 50
Question 3 - 50

  • Why might a person who is HIV+ not have insurance?


Answer 3 50
Answer 3 – 50

  • 1) cost

  • 2) pre-existing condition

  • 3) gov’t benefits don’t kick in until they are very sick


Question 4 10
Question 4 - 10

  • True or false: Small businesses are fined if they do not offer their employees insurance.


Answer 4 10
Answer 4 – 10

  • False: large employers are fined


Question 4 20
Question 4 - 20

  • What is the Individual Mandate?


Answer 4 20
Answer 4 – 20

  • Provision that states that all people must have health insurance or else pay a fine


Question 4 30
Question 4 - 30

  • How old can a young person stay under his/her parents’ health plans?



Question 4 40
Question 4 - 40

  • Give me 2 provisions that the insurance companies would dislike.


Answer 4 40
Answer 4 – 40

  • Possible answers:

    • Guaranteed coverage

    • Cannot base premiums off of health status

    • Cannot drop coverage because you are sick

    • No lifetime limits


Question 4 50
Question 4 - 50

  • What are your options if you make too much for Medicaid, but too little to afford private insurance under the ACA?


Answer 4 50
Answer 4 – 50

  • Government subsidies


Question 5 10
Question 5 - 10

  • What is Ms. Mueller’s favorite color?



Question 5 20
Question 5 - 20

  • True or false: Ms. Mueller has held a snake before.



Question 5 30
Question 5 - 30

  • What is Ms. Mueller’s alarm set for in the mornings?

    • A: 6:30

    • B: 3:00

    • C: 4:30

    • D: Ms. Mueller never sleeps


Answer 5 30
Answer 5 – 30

  • 4:30 (although I press the snooze a few times before getting up)


Question 5 40
Question 5 - 40

  • How much was taken out of Ms. Mueller’s paycheck for her health insurance?


Answer 5 40
Answer 5 – 40

  • Around $20


Question 5 50
Question 5 - 50

  • What time is Ms. Mueller’s bedtime?

    • A) 11:00

    • B) 10:30

    • C) Ms. Mueller doesn’t sleep

    • D) 9:30



ad