Term
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Definition
| a form of protection that eases the financial burden people may experience as a result of illness or injury |
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Term
| how is health insurance paid for? |
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Definition
| You pay a premium (fee) to the insurance company and in return, the insurance company pays for medical costs. (different insurance plans have varying costs and cover different medical costs; expensive insurance plans cover more medical costs) |
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Term
| What do health insurance plans cover? |
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Definition
| depending on the plan, they could cover hospital stays, doctor's visits, medications, vision and dental care |
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Term
| 2 types of health insurance |
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Definition
medical expense insurance
disability income insurance |
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Term
| What does medical expense insurance cover? |
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Definition
| typically on the actual medical costs |
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Term
| What does disability income insurance cover? |
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Definition
| pays money to make up for missed wages due to being unable to work (because sick or injured) |
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Term
| 3 different health insurance plans (how it can be purchased) |
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Definition
group health insurance
individual health insurance
COBRA |
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Term
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Definition
Employer plans - usually the employer offers that plan and pays part of the cost (premium)
Labor unions and professional associations could also offer group plans |
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Term
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Definition
| if you are married, you can combine the benefits of your plan with spouse's plan |
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Term
| individual health insurance |
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Definition
| Usually used by people who do not work for a company, but are self-employed. But anyone can buy it. It can be purchased from any insurance company as individual or family coverage. Rates vary widely |
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Term
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Definition
Consolidated Omnibus Budget Reconciliation Act of 1986
allows employee who loses job, to keep the former employer's group coverage for a set period of time and pay the entire amount (no company contribution) |
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Term
| types of health insurance coverage |
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Definition
| Basic, Major Medical, Hospital Indemnity, Dental, Vision, Dread Disease, Long-term Care |
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Term
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Definition
| covers hospital or nursing home (includes anesthesia, dressings, X-rays, operating room), surgical and doctor expenses. Limits for number of days in hospital and how much they will pay per day or per procedure. |
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Term
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Definition
Better than Basic - pays large costs involved with long hospital stays and multiple surgeries. Almost every type of care and treatment in and out of hospital is covered.
There could be a deductible (an amount you pay before insurance kicks in) |
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Term
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Definition
percentage of expenses that the person pays in addition to the deductible
(for instance, person pays first $500 (deductible) plus 20% of all other bills, the 20% is the coinsurance) |
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Term
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Definition
| Person pays all costs up to a certain amount, then the insurance pays 100% of the rest |
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Term
| Comprehensive Major Medical |
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Definition
| type of complete health insurance that helps pay hospital, surgical, medical and other bills. Has low deductible ($200-300) |
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Term
| Hospital Indemnity Policy |
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Definition
| pays benefits when you are in the hospital, but do not directly cover medical costs. Person is paid in cash and then they can spend it on medical or non-medical expenses |
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Term
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Definition
| usually pays for dental services and supplies (cleanings, exams, extractions, oral surgery, dentures, braces, xrays) |
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Term
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Definition
| pays for eye exams, glasses, contacts, eye surgery, treatment of eye diseases |
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Term
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Definition
| Covers very specific conditions that are not covered by major medical. Illegal in some states. Sold through mail, newspapers, magazines |
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Term
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Definition
| Covers daily help if you become seriously ill or disabled and unable to care for yourself (nursing home or help at home with dressing, bathing, household chores) |
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Term
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Definition
| Amount paid by person every time a service is received (doc visit) |
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Term
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Definition
| Insurance Company cannot cancel the policy unless you fail to pay premiums and cannot increase cost |
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Term
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Definition
| state organizations - Blue Cross covers hospital care, Blue Shield covers surgical and medical services performed by doctors |
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Term
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Definition
| designed to control the cost of healthcare; based on the idea that preventive care will reduce future medical problems |
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Term
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Definition
| health maintenance organization - plan that directly employs or contracts with selected, approved doctors |
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Term
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Definition
| preferred provider organization - group of doctors that agree to provide specific services at agreed upon fees |
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Term
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Definition
| point of service plan - combines features of hmo and ppo |
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Term
| government health care programs |
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Definition
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Term
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Definition
| government paid health care for people over 65 or with disabilities |
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Term
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Definition
| government paid plan for low-income people |
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Term
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Definition
| covers loss of income if a person can't work; people have a small amount of money taken out of their paycheck for disability. If they can't work, they get paid from disability |
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Term
| Sources of disability income |
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Definition
| worker's compensation, employer, social security, private income insurance programs |
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Term
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Definition
| insurance that is paid to your beneficiary (usually spouse or child) if a person dies |
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Term
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Definition
| person who gets paid in case of death (life insurance) |
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Term
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Definition
| insurance that provides protection against loss of life for only a specified term, or period of time, also called temporary life insurance |
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Term
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Definition
| in whole life policy, the accumulated savings to which you are entitled when and if you cancel the policy |
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Term
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Definition
| life insurance that provides coverage for a specific period of time and pays a sum of money to the policyholder if he or she is living at the end of the endowment period |
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Term
| assisted- living facility (ALF) |
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Definition
| housing complex that provide personal and medical services for the elderly |
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Term
| defined-contribution plan |
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Definition
| Individual retirement account plan for each employee when the employer contributes money annually |
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Term
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Definition
| money comes out of each paycheck to go into a savings plan for retirement (sometimes employers will match the amount the employee puts in) |
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Term
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Definition
| a time period after which the employee can keep the employer contributions |
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Term
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Definition
| plan that specifies the benefits an employee will receive at retirement age, based on total earnings and years on the job |
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Term
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Definition
| special account where a person saves a portion of income for retirement |
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Term
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Definition
| also called H.R.10 plan or self-employed retirement plan - retirement plan for self-employed people |
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Term
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Definition
| a contract purchased from an insurance company that guarantees a future fixed or variable payment to the purchaser for a certain number of years or life |
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Term
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Definition
| people who have legal rights to your assets after you die |
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Term
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Definition
| all property and assets owned by an individual |
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Term
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Definition
| detailed plan for managing estate after death |
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Term
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Definition
| person who is named to receive a portion of someone's estate |
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Term
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Definition
| legal declaration of a person's wishes as to their estate after death |
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Term
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Definition
| if you die without a will you are intestate |
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Term
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Definition
| arrangement in which a designated person known as a trustee manages assets for the benefit of someone else |
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Term
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Definition
| legal procedure of proving that a will is valid or invalid |
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Term
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Definition
| person who will carry out a will |
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Term
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Definition
| person who will accept responsibility for caring for children if parents die |
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Term
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Definition
| document that explains, adds, deletes provisions from an existing will |
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Term
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Definition
| legal document where you state your wishes on whether you want to be kept alive by artificial means if you are terminally ill |
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Term
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Definition
| legal document that authorizes someone to act on your behalf |
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