Glossary of health coverage and medical terms this glossary defines many commonly used terms, butisnt a full list. This is the share of the cost you pay for health care received after you meet your deductible. Health insurance glossary pdf top rated treatment centers drug and alcohol addiction can have lasting effects on many facets of an individuals life. A complaint that you communicate to your health insurer or plan. Glossary of health coverage and medical terms this glossary defines many commonly used terms, but isnt a full list. Braided funding, the process of combining funds from different sources to. Health insurance glossary understanding health care.
Webmd provides definitions of terms related to health insurance, the affordable care act and medicare. You can download a printer friendly pdf copy of the mcqa glossary here. Glossary of health insurance and medical terms page 1 of 4 glossary of health insurance and medical terms this glossary has many commonly used terms, but it isnt a full list. Learn the meanings of common health insurance terms like premium, deductible, coinsurance, copay, and guaranteed issue. Basic insurance terminology and definitions about life, health, automobile and home insurance to help you understand basic concepts and buy the right insurance. This limit never includes your premium, balance billed charges or health care your health insurance or plan doesnt cover.
A glossary of terms for community health care and services for older persons. Medical insurance glossary of terms health medicare pdfs. Mcqa glossary of terms texas department of insurance texas. Proposalform filled in by a person wanting to take out insurance. Glossary of health coverage and medical terms this glossary has many commonly used terms, but isnt a full list. See if you qualify for a special enrollment period. These health insurance terminologies will give you a better understanding of health.
Additional health insurance products such as vision or dental insurance that may be added to a medical insurance plan for an additional fee. Health maintenance organization hmo a health care system that assumes both the financial risks associated with providing comprehensive medical services insurance and service risk and the responsibility for health care. However, section 12 of aca gives states the flexibility to require the merger of the individual and small group health insurance. The text of this publication, or any part thereof, may not be reproduced in any manner whatsoever without written. Some of these terms also might not have exactly the same meaning when.
Insurance is an intricate product and so is its glossary. Health insurance glossary terms hawaii department of. These glossary terms and definitionsare intended to be educational and may be different from the terms and definitions in your plan or health insurance policy. These glossary terms and definitionsare intended to be educational and may be different from the terms and definitions in your plan or health insurance. A contract that requires your health insurer to pay some or all of your health. This type of health care is offered by hospitals and independent treatment. A contract that requires your health insurer to pay some or all of your health care.
Life and health insurance license exam manual, 2nd edition 2010 kaplan, inc. This glossary is available to give you general information about words and terms. A contract that requires a health insurer to pay some or all of your health care costs in exchange for a premium. Glossary of health insurance terms december 12, 2008. This page provides a glossary of insurance terms and definitions that are commonly. Glossary of health coverage and medical terms page 1 of 4 glossary of health coverage and medical terms this glossary has many commonly used terms, but isnt a full list. Selecting a top rehab isnt a decision to be arrived at. Ppos and pos plans combine features from both feeforservice and hmos.
Legal entitlement to payment or reimbursement for your health care costs, generally under the contract with a health insurance company. Access plans wc network and health an action plan filed with the texas. Our comprehensive, easytouse glossary provides definitions for common health insurance terms to help you better understand your health care. An insurance plan thats certified by the health insurance marketplace, provides essential health benefits, follows established limits on costsharing like deductibles, copayments, and outofpocket maximum amounts, and meets other requirements under the affordable care act. There are both private and public health insurance plans, with different plans offering different benefits. Insurance glossary india a to z terms of insurance. That is why choosing a health insurance plan that is right for you, and understanding how it works, may seem confusing. Health insurance glossary insurance compare insurance. Actuary a professional trained in the mathematics of insurance and risk management, including the calculations of. The member or spouse can get some life insurance benefits as an early payment. A health insurance contract may also be called a policy or plan. Big blue cross plans to create national health insurer.
In most studies on hospital merger effects, the unit of observation is the. The uniform glossary of health coverage and medical terms was developed as part of the health care reform affordable care act by the department of health and human services, department of labor, and the internal revenue service to meet the requirements of the summary of benefits and coverage document provision this glossary. Health care services that your health insurance or plan doesnt pay for or cover. Getting to know and understand the terms can go a long way to help you understand the plan and thus choosing the best one. Health maintenance organization hmo a health care system that assumes both the financial risks associated with providing comprehensive medical services insurance and service risk and the responsibility for health care delivery in a particular geographic area to hmo members, usually in return for a fixed, prepaid fee. It permits financial services companies to merge and engage in a variety of. The account may be funded by an individual, an employer or both. When making decisions about health coverage, consumers should know the specific meanings of terms used to. A health insurance plan with higher monthly premiums and little to no deductible. Consumer glossary national association of insurance.
A company owned solely or in large part by one or more non insurance entities for the primary purpose of providing insurance. Why is it important to know about health insurance. The discontinuance of an insurance policy before its normal expiration date, either by the insured or the company. The groups joining to form a cooperative must be similar in the. These glossary terms and definitions are intended to be educational and may be different from the terms and definitions in your plan or health insurance. Ppaca requires that everyone who can purchase health insurance for less than 8% of their household income do so or pay a tax penalty. Two large operators of blue cross and blue shield health insurance plans announced what they are calling a strategic affiliation that will merge key management and operational functions. Health insurance glossary health insurance definitions. Health insurance a generic term applying to all types of insurance indemnifying or reimbursing for losses caused by bodily injury or illness including related medical expenses.
An independent agent represents more than one company. Efforts to improve access often focus on providingimproving health coverage. Compare plans side by side, get health insurance quotes, apply online and find affordable health insurance. Federal health plan merger enforcement is consistent. Aggregate cost payments method of reimbursement of a health plan with a. A person must be covered by a qualified high deductible health plan hdhp to contribute to an hsa.
These glossary terms and definitionsare intended to be educational and may be different from the terms and definitions in your plan. A government program that provides health coverage to some citizens who are younger than 65 years of age who cant afford private health insurance. Some health insurance or plans dont coun t all of your copayments, deductibles, co insurance. Glossary of insurance terms actuary a professional trained in the mathematics of insurance and risk management, including the calculations of premiums, policy reserves and other values. Insurance terminology north american training group. Here we have listed and defined a few common terms used in health insurance. Medicare a government program which provides health. Glossary of health coverage and medical terms page 1 of 6 glossary of health coverage and medical terms this glossary defines many commonly used terms, but isnt a full list.
Health care terminology glossary aaahcc american accreditation health care commission aahcc accreditation is an important quality seal of approval for provider networks and managed. Inaccuracies or omissions accidental or deliberate in a proposal may invalidate any insurance. Individual market the market for health insurance coverage offered to individuals other than in connection with a. If your plan has a 20% coinsurance, your insurance may pay 80% of the cost and you might pay 20%. Agent the insurance company representative who sells policies on behalf of the insurer. At the end of this guide, there is a glossary of health insurance terms. The web browser you are using will no longer be supported by. Insurance regulatory information system iris a baseline solvency screening system for the national association of insurance commissioners naic and state insurance regulators established in the mid1970s. Insurance holding company system consists of two or more affiliated persons, one or more of which is an insurer. But once you meet your outofpocket maximum, your insurance. The maximum dollar amount that your health insurance company will pay a health care provider for a benefit i.
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