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HEALTH INSURANCE

Mrs. Vullo

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Across
1.An open-ended health maintenance organization that allows the enrollee to choose HMO, PPO, or indemnity coverage at the time the services are received..
6.The grand total of an insured individual's co-insurance payments and copayments. (4 Words)
9.A physician who serves as a group member's primary contact within the health plan.
10.Government health insurance for persons age 65 or older.
11.A group of doctors, hospitals, and other providers contracted to provide services to insured individuals for less than their usual fees.
15.Expenses that are not covered under an insurance plan.
16.The amount an individual must pay before a plan begins paying insurance benefits
19.A formal request made by an insured person for the benefits provided by a policy.
20.Traditional insurance plans which permit insured individuals to choose their doctors and hospitals. Individuals do not have to choose from a specific list of providers. (2 Words)
21.A mathematician in the insurance field, responsible for calculating premiums, developing plans, and defining risk.
23.The amount an individual must pay when a medical service is received. The rest is is the responsibility of the insurance company.
24.Minimal health insurance coverage after COBRA benefits have expired. Premiums may be two to three times the rate of a standard policy
25.Person responsible for the administration of the patient's treatment and coordinates and authorizes all medical services
Down
2.the dollar amount of claims filed for eligible expenses at which the insurance begins to pay at 100% per insured individual. This is reached when a person has paid the deductible and reached the out-of pocket maximum amount of co-insurance. (2 Words)
3.An association that contracts with a group of doctors to provide care at prearranged rates or discounts.
4.Accounts offered and administered by employers that provide a way for employees to set aside pre-tax dollars out of their paycheck to pay for the employee's share of health insurance premiums. Typically, benefits must be used within the given benefit year. (3 Words)
5.An alternative to commercial insurance that stresses preventative care and requires enrollees to see a primary care physician who can refer them to a specialist if needed.
7.A savings account designated for out-of-pocket medical expenses. Employers and employees are allowed to contribute to a savings account on a pre-tax basis and carry over unused funds at the end of the year
8.The coordination of health care services in the attempt to produce high quality health care for the lowest possible cost. (2 Words)
10.Government health insurance for persons with low income.
12.An insurance company requirement that an insured person obtain pre-approval before being admitted to a hospital or receiving certain kinds of treatment.
13.The chance of finacial loss that an insurance company takes when it agrees to cover a particular group
14.A form of medical cost sharing that requires a person to pay a stated percentage of medical expenses after the deductible amount.
17.Payments to an insurance company providing coverage.
18.The transfer to a specialty physician by a primary care physician within many mangaged care plans.
22.Health insurance for terminated employees for up to 18 months. Individuals pay 100% of the cost

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