11 terms


Medicare Part A
hospital insurance plan that covers services provided by hospitals, SNF, home health programs, hospice and nursing homes- financed by employees and emplyers through the Social Security System
Medicare Part B
insurance plan that covers physicians' services and is paid for by federal taxes and monthly premiums from beneficiaries
Medicare Part C
Medicare Advantage Plans that are offered through private insurance companies that provide both hospital and physician coverage and possible prescriptions - financed by Social Security and monthly premiums
Medicare Part D
prescription drug coverage offered through private companies and financed through premiums from beneficiaries
Family and Medical Leave Act
requires employers of 50+ employees and all public agencies to provide up to 12 weeks of unpaid, job protected leave to eligible employees for health related problems of the employee or family member
Indian Health Service
agency of the US DHHS that provides hospital, dental and health benefits, substance abuse counceling, public health nursing and other services to American Indians and Alaskan Natives
Prospective payment system
payment rate to the healthcare facility is predetermined based on medical diagnosis, treatment or other information regardless of the cost of care for a specific patient
Per discharge payment
provider or hospital is paid one sum for all services delivered during stay
Per diem payments
paid one sum for all services delivered to a patient during one day
prohibits group insurance plans from including eligibility criteria related to health status, medical history, genetic information or disability and reduces exclusions for preexisting conditions when a person was previously covered by a health plan
gives people the right to continued health plan coverage for up to 18 months after voluntary or involuntary termination of employment or reduction in work hours. The person must pay the entire premium