HSA 4109 Lecture Notes - Lecture 3: Essential Health Benefits, Co-Insurance, Copayment
4 Oct 2017
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How to choose a healthcare plan: out-of-pocket costs, covered benefits, provider network, drug formulary. Includes deductibles, co-insurance, copayments, or other similar charges benefits: moop limit for health insurance exchanges, set each year by cms, centers for medicare & medicaid services. In-network preventative services with no cost sharing: 10 essential health benefits, laboratory services, emergency services, prescription drugs, mental health and substance use disorder services, maternity and newborn care, pediatric services. Managed care lecture notes part 3: oral and vision care, rehabilitative and habilitative services and devices, ambulatory patient services, preventative and wellness services and chronic disease management, hospitalization. Provider networks: facilities, providers, and suppliers" health insurers have contracted with to provide healthcare services. In network: providers are covered, also called preferred or participating providers, out of network, providers are not covered, members may pay a higher cost sharing amount to see the provider.
