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TriCare Limited
Tricare (styled TRICARE) is a health care program of the United States Department of Defense Military Health System. Tricare provides civilian health benefits for U.S Armed Forces military personnel, military retirees, and their dependents, including some members of the Reserve Component. Tricare is the civilian care component of the Military Health System, although historically it also included health care delivered in military medical treatment facilities. Tricare functions similar to a single-payer healthcare system. The Tricare program is managed by the Defense Health Agency (DHA). Before 1 October 2013, it was managed by the Tricare Management Activity (TMA) under the authority of the Assistant Secretary of Defense (Health Affairs). On that date, TMA was disestablished and Tricare responsibility was transferred to the newly established DHA. The Department of Defense operates a health care delivery system served approximately 9.4 million beneficiaries in 2018. The Departme ...
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Health Care Provider
A health care provider is an individual health professional or a health facility organization licensed to provide health care diagnosis and treatment services including medication, surgery and medical devices. Health care providers often receive payments for their services rendered from health insurance providers. In the United States, the Department of Health and Human Services defines a health care provider as any "person or organization who furnishes, bills, or is paid for health care in the normal course of business." Individual providers In the United States, the law defines a healthcare provider as a "doctor of medicine or osteopathy who is authorized to practice medicine or surgery" by the state, or anyone else designated by the United States Secretary of Labor as being able to provide health care services. In general, this is seen to include: * Physician, a professional who practices medicine * Advanced practice provider, a trained health worker who has a defined scope ...
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Copayment
A copayment or copay (called a gap in Australian English) is a fixed amount for a covered service, paid by a patient to the provider of service before receiving the service. It may be defined in an insurance policy and paid by an insured person each time a medical service is accessed. It is technically a form of coinsurance, but is defined differently in health insurance where a coinsurance is a percentage payment after the deductible up to a certain limit. It must be paid before any policy benefit is payable by an insurance company. Copayments do not usually contribute towards any policy out-of-pocket maximum, whereas coinsurance payments do. Insurance companies use copayments to share health care costs to prevent moral hazard. It may be a small portion of the actual cost of the medical service but is meant to deter people from seeking medical care that may not be necessary, e.g., an infection by the common cold. In health systems with prices below the market clearing level in wh ...
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