1.03 Healthcare Finances. 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Finances Private Finances 2

Download 1.03 Healthcare Finances. 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Finances Private Finances 2

Post on 27-Mar-2015

231 views

Category:

Documents

6 download

Embed Size (px)

TRANSCRIPT

<ul><li>Slide 1</li></ul> <p>1.03 Healthcare Finances Slide 2 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Finances Private Finances 2 Slide 3 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Funded by taxes 3 Slide 4 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Medicare Pays 80% of the charges for care Serves patients Over age 65 Over age 65 Who have received social security disability benefits for at least 2 years Who have received social security disability benefits for at least 2 years With end stage renal disease With end stage renal disease 4 Slide 5 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Medicare Plans A hospital care B outpatient medical care C- advantage plan D medication 5 Slide 6 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Medicare Plan A The original Medicare plan Automatically enrolled unless the patient specifically enrolls in a Medicare Advantage Plan (Part C) Fee-for service Pay a deductible and co-pay 6 Slide 7 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Medicare Plan A Hospital insurance at no cost to most people Coverage includes inpatient care skilled nursing facilities critical access hospitals hospitalshospice home health 7 Slide 8 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Medicare Plan B Pays for necessary medical services and supplies Most people pay a premium for Plan B Covers outpatient care doctors services physical or occupational therapies additional home healthcare 8 Slide 9 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Medicare Plan C Combination of Part A and Part B Provided through private insurance companies approved by Medicare Option of adding Part D Includes HMOsPPOs Private fee-for-service plans Medicare special needs 9 Slide 10 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Medicare Plan D stand-alone prescription drug coverage most people pay a premium plans vary and cover different drugs can choose the best plan for patients needs 10 Slide 11 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Medigap A private individual insurance policy that pays the difference between the charges for care and the amount Medicare pays. 11 Slide 12 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Medicaid Provides Provides healthcare for: people with low incomes children who qualify for assistance people who are disabled or blind 12 Slide 13 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Medicaid Funded by federal government but regulated by individual state government Not all people with low income qualify 13 Slide 14 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government TRICARE Military health plan Serves: Active duty personnel and family Survivors of military personnel Retired military personnel 14 Slide 15 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Government Veterans Health Administration P rovides healthcare services to former military personnel 15 Slide 16 Journal prompt. students answer these questions on the back of the handout or in their notebooks. Explain how a patient might be eligible for both Medicare and Medicaid benefits. What are some healthcare costs the patient will have to pay, even with support from government finance? Slide 17 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Private Private Insurance Individual insurance plan, the insured pays the total amount of the monthly premium Group insurance plan the insured individual and their employer share the amount of the monthly premium 17 Slide 18 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Private Health Maintenance Organization (HMO) care is directed toward prevention of disease patient must see only HMO approved providers pay a monthly fee, no additional charge for care care from non-HMO provider generally not covered 18 Slide 19 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Private Preferred Provider Organization (PPO) Group of doctors and/or hospitals that provide care to a specific group PPO provides services to the insured at a reduced rate Usually require a deductible and a co-pay Less coverage for treatment provided by non- PPO provider 19 Slide 20 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Private Indemnity Plan Traditional plan with freedom to visit physician of choice No referral required by insurance company Pay up front Get reimbursed amount allowed by insurance policy; amounts may vary 20 Slide 21 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Private Out of pocket CASH 21 Slide 22 1.03 Understand healthcare agencies, finances, and trends Healthcare Finances Private Workers Compensation http://www.comp.state.nc.us Pays for the healthcare of workers injured on the job 22 Slide 23 Journal prompt answer these questions on the back of the handout or in their notebooks. Compare an HMO and a PPO. What are some costs the patient will have to pay? Slide 24 Math Handout and Journal prompt Health Insurance Math handout. complete the assignment as directed What they think happens to the patient that is not able to pay for their healthcare. Where would the patient that cannot pay go for healthcare? Slide 25 Slide 26 Complete Crossword </p>