Dr. Oz Explains The Healthcare System

Question

1 Video Dr Oz Explains The Healthcare System Please define the following health insurance related terms and give examples on each using your own words: Deductible: Copayment: Coinsurance: Out of pocket maximum. Use the following information to answer the following questions. Deductible: $1,000. Coinsurance: 20%. Out-of-pocket maximum: $8,000. Let's say you have $30,000 in covered medical expenses in January: How much are you going to pay? How much does the insurance company pay? If you have additional $20,000 in medical expenses: How much are you going to pay? How much does the insurance company pay? How does Medicare work and how is it funded? What services are covered with Medicaid and how are states involved to fund and administer the program? Define behavioral economics. What kind of incentives can be used to design better healthcare? Include extent of effectiveness in your comments. How can social media be used to design better healthcare? Is healthcare a right or luxury?

Dr. Jack HW Helper · Accepted Answer

Introduction to Healthcare Terms Understanding the intricacies of health insurance is essential for navigating the healthcare system effectively. Key terms include deductible, copayment, coinsurance, and out-of-pocket maximum, each with distinct implications for both the consumer and the insurer. Deductible A deductible is the amount a policyholder must pay out-of-pocket before their health insurance begins to cover expenses. For instance, if an individual has a deductible of $1,000, they must pay the first $1,000 of their covered medical expenses before their insurance policy starts to contribute. Copayment A copayment, or copay, is a fixed amount that a policyholder pays for a specific service, such as a doctor’s visit or prescription medication. For example, if a patient visits a doctor and has a copayment of $30, they pay that amount regardless of the total bill, with the insurance covering the rest. Coinsurance Coinsurance refers to the percentage of costs the policyholder pays after meeting their deductible. For instance, if the coinsurance is 20%, after the deductible is met, the insured would be responsible for 20% of the remaining medical costs, while the insurer covers the other 80%. Out-of-Pocket Maximum The out-of-pocket maximum is the limit on the total amount a policyholder pays in a plan year. Once this limit is reached, the insurance company covers 100% of additional costs. For example, if the maximum is $8,000 and an individual incurs significant medical expenses, they will not pay more than this amount in out-of-pocket expenses. Calculating Payments for Medical Expenses In January, a person incurs $30,000 in covered medical expenses. Here’s how that breaks down: Pay the deductible: $1,000 Remaining amount: $30,000 - $1,000 = $29,000 Coinsurance payment: 20% of $29,000 = $5,800 Total paid: $1,000 + $5,800 = $6,800 Insurance company pays: $30,000 - $6,800 = $23,200 If the individual incurs an additional $20,000 in expenses, the calculation would be a

Dr. Oz Explains The Healthcare System ✓ Solved

1 Video Dr Oz Explains The Healthcare System

Paper For Above Instructions

Introduction to Healthcare Terms

Deductible

Copayment

Coinsurance

Out-of-Pocket Maximum

Calculating Payments for Medical Expenses

Understanding Medicare

Overview of Medicaid

Behavioral Economics in Healthcare

Social Media in Healthcare Design

Healthcare: A Right or Luxury?

Conclusion

References