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  2. Medicare Advantage - Wikipedia

    en.wikipedia.org/wiki/Medicare_Advantage

    The largest operator is a hybrid of AARP - an interest group - and UnitedHealth (UHC) - a for-profit private insurance company - who serve as plan operator. AARP licenses the use of its name to UHC; however, UHC also offer their own Medicare Advantage plans, exclusive of any AARP-affiliated plans. [citation needed]

  3. UnitedHealth Group - Wikipedia

    en.wikipedia.org/wiki/UnitedHealth_Group

    Selling insurance products under UnitedHealthcare, and health care services under the Optum brand, it is the world's ninth-largest company by revenue and the largest health care company by revenue. The company is ranked 8th on the 2024 Fortune Global 500. [4] UnitedHealth Group had a market capitalization of $460.3 billion as of December 20, 2024.

  4. HealthCare.gov - Wikipedia

    en.wikipedia.org/wiki/HealthCare.gov

    HealthCare.gov is a health insurance exchange website operated by the United States federal government under the provisions of the Affordable Care Act (ACA), informally referred to as "Obamacare", which currently serves the residents of the U.S. states which have opted not to create their own state exchanges.

  5. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    A response to an eligibility request is returned by the payor through a direct electronic connection, or more commonly their website. This is called an X12-271 "Health Care Eligibility & Benefit Response" transaction. Most practice management/EM software will automate this transmission, hiding the process from the user. [18]

  6. Health insurance marketplace - Wikipedia

    en.wikipedia.org/wiki/Health_insurance_marketplace

    The focus was on creating local or regional exchanges that offered a series of standardized health care plans that reduced the complexity and cost of acquiring or understanding health care insurance, while simplifying claims administration. The system was modeled after the standardized stock exchange and banking industry back office processes ...

  7. Medicaid - Wikipedia

    en.wikipedia.org/wiki/Medicaid

    Medicaid is a government program in the United States that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant ...

  8. Medicaid coverage gap - Wikipedia

    en.wikipedia.org/wiki/Medicaid_coverage_gap

    As initially passed, the ACA was designed to provide universal health care in the U.S.: those with employer-sponsored health insurance would keep their plans, those with middle-income and lacking employer-sponsored health insurance could purchase subsidized insurance via newly established health insurance marketplaces, and those with low-income would be covered by the expansion of Medicaid.

  9. Federal Employees Health Benefits Program - Wikipedia

    en.wikipedia.org/wiki/Federal_Employees_Health...

    The Federal Employees Health Benefits (FEHB) Program is a system of "managed competition" through which employee health benefits are provided to civilian government employees and annuitants of the United States government. The government contributes 72% of the weighted average premium of all plans, not to exceed 75% of the premium for any one ...

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