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An individual must pay any amount above this limit for the dental care they receive. Aetna also offers a discount card that provides savings of 15% to 50% off the cost of many dental services.
Stop-loss insurance is a form of reinsurance that insures self-funded plans and their assets. Due to the limited assets at the disposal of an average employer as compared to an insurance company, an employer could easily bankrupt itself if its employees incur a large number of high-dollar claims and the employer is unable to fund them all. This ...
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Aetna Inc. (/ ˈ ɛ t n ə / ET-nə) is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare.
This is a form of the "Beveridge Model" of health care systems that features public health providers in addition to public health insurance. [ 27 ] The term "Scandinavian model" or "Nordic model" of health care systems has a few common features: largely public providers, limited private health coverage, and regionally-run, devolved systems with ...
Examples included litigation between Aetna and a group of surgical centers over an out-of-network overbilling scheme and kickbacks for referrals, where Aetna was ultimately awarded $37 million. [25] While Aetna has led the initiative, other health insurance companies have engaged in similar efforts. [26]
The German healthcare system had introduced copayments in the late 1990s in an attempt to prevent overutilization and control costs. For example, Techniker Krankenkasse-insured members above 18 years pay the copayments costs for some medicines, therapeutic measures and appliances such as physiotherapy and hearing aids up to the limit of 2% of the family's annual gross income.
Prescription drug plans are a form of insurance offered through some health insurance plans. In the U.S., the patient usually pays a copayment and the prescription drug insurance part or all of the balance for drugs covered in the formulary of the plan. [5]: TS 2:21 Such plans are routinely part of national health insurance programs. For ...