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Outpatient
Health Insurance Information
Three Categories:
A. Medicare - Federal
1
Age 65 or Older
2
Disabled
3
Chronic Renal Disorder
Assigned: Participating providers
agree to accept approved amount of charges. The patient is responsible for:
1 Any Deductible
2 Co-Pay and some Non-Covered Charges
Non-Assigned:
Medicare payment sent directly to recipient and
the recipient is responsible for difference between Medicare and physician’s
charge
B. Medicaid – Federal & State
(Many physicians do not accept Medicaid, but those who do bear all costs.)
1 Low Income
2 Age 65 or Older
3 Blind
4 Disabled
Mental health professionals vary on whether they are Medicaid providers.
C. Private Insurance Carriers:
A contract between the carrier and insured
provides for specific coverage. A deductible that the individual must pay may
apply, and after this is satisfied, benefits are paid based on the contract
agreement (i.e. 80/20).
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