"Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses."
Analysis of health insurance mechanisms, including risk pooling, adverse selection, moral hazard, and insurance market regulation.
Health Insurance Fundamentals: This topic covers the basics of health insurance such as types of plans, coverage, and premiums.
Health Care System: This topic covers the structure of the health care system in the United States, including the roles of insurers, providers, and patients.
Health Care Financing: This topic covers how health care is funded and financed, including government programs, employer-sponsored plans, and individual policies.
Health Care Reform: This topic covers the Affordable Care Act, its benefits and drawbacks, and proposed reforms.
Health Insurance Markets: This topic covers the mechanics of health insurance markets, including supply and demand, underwriting, and risk management.
Health Insurance Regulation: This topic covers federal and state health insurance regulations, including the role of the government in protecting consumers.
Health Insurance and Public Policy: This topic covers the public policy choices that influence health insurance markets, including tax policy, health care spending, and health care access.
Health Insurance Law: This topic covers the legal aspects of health insurance, including contracts, torts, and constitutional law.
Health Economics and Health Outcomes: This topic covers the relationship between health economics and health outcomes, including morbidity and mortality.
Health Care Technology: This topic covers the impact of technology on health care costs and outcomes, including telemedicine, electronic health records, and medical devices.
Public Health and Preventive Medicine: This topic covers the relationship between health insurance and public health, including the role of preventive medicine in health care costs.
Health Behavior and Health Literacy: This topic covers how health behavior and health literacy affect health outcomes, including factors such as diet, exercise, and patient engagement.
Population Health: This topic covers the impact of population health trends on health insurance markets, including social determinants of health and health disparities.
Health Care Ethics: This topic covers ethical issues in health care, such as access and affordability, informed consent, and end-of-life care.
Private Health Insurance: This is an insurance plan that an individual or their employer purchases that covers medical expenses. The individual or employer pays a monthly premium and may also have a deductible and/or copayments for certain medical services.
Group Health Insurance: This type of health insurance is provided to groups of people, typically through an employer or an organization. The coverage and cost are usually negotiated by the employer, and the premiums are often split between the employer and employees.
Individual Health Insurance: This is a type of health insurance that an individual purchases for themselves and their family. They pay the premium and may also have a deductible and/or copayment.
Family Health Insurance: This is a type of health insurance that provides coverage for an entire family. The premium is based on the number of people covered and may also have a deductible and/or copayment.
Catastrophic Health Insurance: This insurance is designed to provide protection against catastrophic medical expenses, typically with high deductibles and low premiums.
Short-term Health Insurance: This type of insurance provides coverage for a limited period, such as a few months to a year. It is often used as a stopgap measure when someone is between jobs, or waiting for other insurance to take effect.
High-deductible Health Insurance: This insurance has a high deductible, typically $1,000 or more, but with lower premiums. These plans are often paired with a Health Savings Account (HSA), which allows individuals to save pre-tax dollars to use towards their deductible.
Medicare: Medicare is a government-run health insurance program for people over age 65 as well as those with certain disabilities.
Medicaid: This is a government-run insurance program for low-income individuals and families, which is jointly funded by the federal and state governments.
Affordable Care Act (ACA) Health Insurance Exchange Plans: These plans are available through the federal or state-run health insurance exchange and must comply with the ACA’s requirements for benefits and cost-sharing.
Health Maintenance Organization (HMO) Plans: These plans require patients to use a network of doctors and hospitals to receive healthcare services, and often require a referral from a primary care physician for specialist care.
Preferred Provider Organization (PPO) Plans: These plans allow patients to use providers within a network at a reduced cost, but patients may still see providers outside of the network for an additional cost.
Point-of-Service (POS) Plans: This type of plan combines elements of HMO and PPO plans, and may require patients to choose a primary care physician and obtain referrals for specialist care, but also allow them to see providers outside of the network.
Exclusive Provider Organization (EPO) Plans: These plans usually have a select group of providers that are covered, and patients may not be able to see providers outside of this network.
Medicare Advantage Plans: Also known as Medicare Part C, these plans are offered by private insurers and provide Medicare beneficiaries with additional benefits beyond what is covered by traditional Medicare.
"As with other types of insurance, risk is shared among many individuals."
"An insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement."
"The benefit is administered by a central organization, such as a government agency, private business, or not-for-profit entity."
"According to the Health Insurance Association of America, health insurance is defined as 'coverage that provides for the payments of benefits as a result of sickness or injury.'"
"It includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment."
"By estimating the overall risk of health risk and health system expenses over the risk pool, an insurer can develop a routine finance structure."
"A person incurring medical expenses."
The paragraph does not mention if health insurance is mandatory or voluntary.
"A central organization, such as a government agency, private business, or not-for-profit entity."
"Health insurance or medical insurance is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses."
"An insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement."
"A government agency can administrate health insurance benefits."
The paragraph does not mention whether health insurance covers all medical expenses.
"Risk is shared among many individuals."
"It includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment."
The paragraph does not mention whether health insurance varies from one country to another.
"A central organization, such as a government agency, private business, or not-for-profit entity."
The paragraph does not mention whether health insurance covers pre-existing conditions.
"By estimating the overall risk of health risk and health system expenses over the risk pool, an insurer can develop a routine finance structure."