2026 \latest update with complete questions &
accurate detailed answers
U.S. government health insurance plan for
a. All military personnel, unmarried children, spouses,
Tricare b. Medal of Honor recipients and their families
3. Reservists and their families.
It is managed and regulated by the department of
defense.
1. HMO
Types of Private Health
Insurance: 2. PRO
Provide preventative health care options at reduced
costs.
It provides and arranges managed care for health
insurances, self-funded healthcare benefit plans,
Health Maintenance individuals, and other entities in the United
Organization (HMO) States.
It acts as a liaison with healthcare providers on a
prepaid basis.
- Low or no premium
- Lower out-of-pocket cost
- Lower co-payments
- Smaller network
- Does not cover out of network
an agreement between entities such a
hospitals, doctors, surgery centers, and
insurance agencies to provide healthcare at
Preferred Provider a reduced amount.
Organization (PPO) - Out of network coverage
- State or Nationwide
- Provider network
, - No referral to see specialist
- Easy to use.
- along with the Health Care and Education
Reconciliation Act of 2010 amendment
represents the most significant policy
expansion and regulatory overhaul to the
United States healthcare since 1965.
- brought changes such as insurance for people
with preexisting conditions, allowing adults to
Affordable Care Act stay on their parent's insurance to age 26,
(ACA)
increased MEdicaid eligibility and more.
- children cannot be denied health insurance because of
preexisting conditions.
- seeks to increase accountability for insurance
company.
- includes preventive services to seniors.
- current and future healthcare reform will focus on
reducing discrimination.
- several challenges claiming provisions
contained in ACA are unconstitutional have
been filed in federal courts.
- aims to reduce disparities and provide health
insurance for all citizens in the United State.
Practice Act National and state laws that govern used to govern
healthcare professionals.
scope of practice a set of regulations and ethical considerations
that define the scope - procedures, actions,
and processes, permitted
Protocols A set of rules that explain how a task or procedure
should be completed
Ethics the principles and standards that govern behavior
Bioethics the ethical implications related to research in healthcare
Health Insurance a federal law established to improve the
, Portability and effectiveness of healthcare delivery, protect
Accountability Act patient rights and improve healthcare quality.
(HIPAA) 1996
- Criminal violation
Penalties for Violations - Civil violation
- termination of employment, fines, and imprisonment