TYPE Of Insurance
There are two kind of Insurance Companies
There are :
Federal Insurance Companies
MOTIVE IS WELFARE
Examples :
Medicare
Medicaid
CHAMPUS (Civilian Health and Medical Program of the Uniformed Services)
CHAMPVA (Civilian Health and Medical Program of the Veterans Administration)
Commercial Insurance Companies
MOTIVE IS PROFIT
Examples:
Aetna
Cigna
BCBS
Humana
MEDICARE ELIGIBILITY
Who is eligible for Medicare?
People age 65 or older
People under age 65 with certain disabilities.
People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).
Decide how to get your Medicare Coverage
Traditional Medicare includes:
Hospital Insurance (Part A)
Medical Insurance (Part B)
You will need a separate plan for your Part D,
Prescription Drug Coverage.
Medicare Advantage Plan:
Combines Part A, Part B and usually Part D
Medicare has Two Parts:
Medicare has Two Parts:
Part A (Hospital Insurance)
Most people don't have to pay for Part A.
Part B (Medical Insurance)
For Part B benefits patient has to pay monthly premium of $99.90 in 2012, a $15.50 decrease over the 2011
premium of $115.40.
Two type of Providers
Participating provider
and
Non-Participating provider
Two type of Providers
What is the difference between "participating" and "non-participating" providers?
Participating provider :-
Participating providers have a signed contract with Insurance.
Benefits:-
More patients
Assured payment from Insurance Company
Need to follow Insurance fee schedule
Non Participating provider :-
Non Participating providers will not have any contract with Insurance.
Benefits:-
Members are responsible for the total amount billed
High value of billed amount
High Copay from patient
High Reimbursement
Disadvantange:-
Less patients visits.
There are two kind of Insurance Companies
There are :
Federal Insurance Companies
MOTIVE IS WELFARE
Examples :
Medicare
Medicaid
CHAMPUS (Civilian Health and Medical Program of the Uniformed Services)
CHAMPVA (Civilian Health and Medical Program of the Veterans Administration)
Commercial Insurance Companies
MOTIVE IS PROFIT
Examples:
Aetna
Cigna
BCBS
Humana
MEDICARE ELIGIBILITY
Who is eligible for Medicare?
People age 65 or older
People under age 65 with certain disabilities.
People of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).
Decide how to get your Medicare Coverage
Traditional Medicare includes:
Hospital Insurance (Part A)
Medical Insurance (Part B)
You will need a separate plan for your Part D,
Prescription Drug Coverage.
Medicare Advantage Plan:
Combines Part A, Part B and usually Part D
Medicare has Two Parts:
Medicare has Two Parts:
Part A (Hospital Insurance)
Most people don't have to pay for Part A.
Part B (Medical Insurance)
For Part B benefits patient has to pay monthly premium of $99.90 in 2012, a $15.50 decrease over the 2011
premium of $115.40.
Two type of Providers
Participating provider
and
Non-Participating provider
Two type of Providers
What is the difference between "participating" and "non-participating" providers?
Participating provider :-
Participating providers have a signed contract with Insurance.
Benefits:-
More patients
Assured payment from Insurance Company
Need to follow Insurance fee schedule
Non Participating provider :-
Non Participating providers will not have any contract with Insurance.
Benefits:-
Members are responsible for the total amount billed
High value of billed amount
High Copay from patient
High Reimbursement
Disadvantange:-
Less patients visits.
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