BB30 Business Law 4.02Summer 2013

* Unit BPersonal Law

Essential Standard 4.00 Understand financial, credit, and insurance law

Health Insurance4.02 C

BB30 Business Law 4.02Summer 2013

Health Insurance

Traditional Health Insurance (Major Medical Coverage)1. What type of coverage does Major Medical Coverage offer?2. What is the main reason for those who elect this type of coverage?3. What is a characteristic of major medical coverage?

Annual Deductible1. What is an annual deductible?2. How does this work?

Major Exclusions for Coverage1. For heath care policies, what do major exclusions include?2. Why do health care insurance providers have these exclusions?

Possible lengthy waiting periods1. What is a “waiting period” in a health insurance policy?

Group Insurance Coverage1. What is group health insurance coverage?2. Why is group health insurance usually better for an employee?

BB30 Business Law 4.02Summer 2013

Managed Health Care 1) HMO

1. What does HMO stand for?2. Do HMO’s allow you to pick your primary care physician?3. How is the majority of your health care provided when you have an HMO as your health insurance?

2) PPO1. What is a PPO health insurance company?2. What are the requirements for their policy holders?3. Can you go to any doctor that you desire?

3)HMO-(POS)1. What is HMO (POS) type health care insurance?2. What are the benefits (if any) of this type of policy?

Individual Insurance Coverage

1. What is individual insurance coverage?

2. What is the primary negative to this type of health insurance?

3. Do people that have health insurance primarily have individual or group health insurance?

BB30 Business Law 4.02Summer 2013

Supplemental Health Insurance Coverage

a. Cancer Insurance Coverage1. What is cancer insurance?2. What is the purpose of cancer insurance?3. Does cancer insurance cover other illnesses?

b. Dental Insurance Coverage1. Is dental insurance a group or individual policy?2. Does dental insurance have restrictions on most policies?3. Why are there restrictions?4. What type of coverage do dental insurance policies generally provide

c. Long Term Medical Coverage1. What does long term medical coverage provide?2. Why might this be a good insurance policy to purchase if you

are in poor health?

BB30 Business Law 4.02Summer 2013

Health Insurance (Continued)

e. Vision Insurance Coverage1. What type of coverage and items does vision insurance normally provide?2. Can you select your own optometrists/ophthalmologist?

Government Insurance CoverageMedicare1. What is Medicare?2. Who provides Medicare?3. Who is eligible for coverage? 4. What is a special consideration for coverage under age?

Medicaid1. What is Medicaid?2. Who provides Medicaid coverage?3. Who is eligible for coverage?4. Do state governments or the Federal government determine eligibility?

BB30 Business Law 4.02Summer 2013

Medigap Insurance1. What is Medigap Insurance?2. Who needs this type coverage?3. Does the government (state or Federal) provide this coverage?

Disability Insurance Coverage1. What is disability insurance?2. Who pays for or provides this type insurance to an employee?