Health insurance coverage is a product that helps consumers have peace of mind in knowing that the coverage will minimize their own risk, yet many consumers have anxiety when trying to select a health plan and use the coverage. This course is designed to help the professionals, who must counsel consumers, focus on the basic concepts and terminology that consumers need to know.
Lesson 1: Why Is Health Coverage Needed and Who Provides It?
Explains why health insurance coverage is so important and the main sources of health coverage in the United States, including employer sponsored health plans and government programs.
Lesson 2: Keys to Understanding Health Coverage
Identifies communication tools used to explain coverage, such as the ACA required summary of benefits and coverage (SBC) or a summary plan description (SPD), as well as the definitions of basic health coverage terms, including who and what is covered under a plan.
Lesson 3: Health Coverage Models
Describes the goal of managed care and how to differentiate between various plan approaches, including a preferred provider organization (PPO), health maintenance organization (HMO) and point-of-service (POS) plan. Also explains how consumer-driven health plans (CDHPs), health reimbursement arrangements (HRAs) and health savings accounts (HSAs) work.
Lesson 4: Other Types of Coverage
Outlines other types of carve-out plans including prescription drug plans, dental plans, vision plans, behavioral health plans and alternative health care.