Medicare for clients over age 65 and/or with permanent disabilities. premiums applied as insurance program reimburses providers based on DRGs. Premiums
... [Show More] applied as Managed Care Organizations (MCOs) provide enrolled clients with comprehensive care overseen by a primary care provider. Is federally funded.
Medicaid for clients with low income. is federally funded and individual states determine eligibility requirements.
Traditional Insurance reimburses for services on fee-for-service basis.
Managed Care Organizations (MCOs) comprehensive care is overseen by a primary care provider & focuses on prevention and health promotion
Preferred Provider Organizations (PPOs) client chooses from a list of contracted providers. using non-contracted providers increases the client's out of pocket costs
Exclusive Provider Organizations (EPOs) the client chooses from a list of providers within a contracted organization
Long-Term Care Insurance provides for long-term care expenses not covered by Medicare
Preventive health care focuses on educating and equipping clients to reduce and control risk factors of disease. Examples include immunizations, stress management programs, and seat belt use
Primary health care emphasizes health promotion, and includes prenatal and well-baby care, nutrition counseling, and disease control. is based on a sustained partnership between client and provider. examples include office or clinic visits and scheduled school/work centered screenings (vision, hearing, obesity)
Secondary health care includes the diagnosis and treatment of emergency, acute illness, or injury. examples include care given in hospital settings (inpatient and EDs), diagnostic centers, or emergent care centers
Tertiary health care involves the provision of specialized highly technical care. examples include oncology centers and burn centers
Restorative health care involves intermediate follow-up care for restoring health. examples include home health care, rehab centers, and skilled nursing facilities
Continuing health care designed to address long-term or chronic health care needs. examples include hospice, adult day care, and in-home respite care [Show Less]