Lecture notes on health insurance 2 of 2 if we want everyone to get health care, then the botton line is that we need to subsidize the sick at least somewhat. The 340b drug pricing program enables eligible health care organizations known as covered entities to purchase drugs from manufacturers at reduced prices. The ability of a doctor to admit a patient to a particular hospital. An individual designated by a policy holder to receive the benefits of an insurance policy. While every effort is made to ensure that this information is accurate and current, scai. Glossary of health coverage and medical terms ksb hospital edited from. Claimant a claimant is a person making a claim for unemployment insurance benefits under any state or federal unemployment compensation program. A group of health care providers who give coordinated care, chronic disease management, and thereby improve the quality of patient care. Webmd provides definitions of terms related to health insurance, the affordable care act and medicare. Usually, traditional or indemnity insurance is the most expensive option for health plan coverage. This glossary of health insurance and healthcare terms defines commonly used terms, is intended for educational purposes and may differ from language used in your policy.
Glossary of healthcare terms health insurance and reform. A glossary pdf,, download ebookee alternative excellent tips for a better ebook reading. On march 23, 2010, president obama signed the patient protection and affordable care act ppaca into law. Glossary of health insurance terms december 12, 2008 experimental or investigational services. Bold text indicates a term defined in this glossary. Most plans, however, place limits or exclusions on treatment, such as limiting the number of days a patient may stay at a treatment facility or the. In a wider context casualty insurance may cover all nonlife insurances. Medical insurance glossary of terms health medicare pdfs. In most states, the federal government runs the marketplace sometimes known as the exchange for individuals and families. Glossary of insurance terms the az for insurance practitioners terms generally associated with reinsurance ab initio a term used to describe avoidance of a contract from its inception or its beginning. Well give you an assist by helping you learn the language of health insurance.
Shorthand for the health insurance marketplace, a shopping and enrollment service for medical insurance created by the affordable care act in 2010. Glossary of health coverage and medical terms university. These glossary terms and definitionsare intended to be educational and may be different from the terms and definitions in your plan. Most plans, however, place limits or exclusions on treatment, such as limiting the number of days a patient may stay at a treatment facility or the number of times a patient may go in for treatment, or requiring care to be either on an inpatient or outpatient basis. A health insurance policy you buy directly from a health insurance company or broker rather than through an employer. Glossary of health coverage and medical terms this glossary has many commonly used terms, but isnt a full list. Health insurance glossary understanding health care. Health insurance glossary of terms health coverage fast blog.
Many insurance plans cover treatment for substance abuse detoxification and treatment. Compare plans side by side, get health insurance quotes, apply online and find affordable health insurance today. Glossary of health coverage and medical terms this glossary defines many commonly used terms, butisnt a full list. The national library of medicines nlm controlled vocabulary database. 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. Health insurance 101 words to know when you need medical care 00. Glossary of commonly used healthcare acronyms and terms. The term property insurance includes many lines of available insurance. These glossary terms and definitions are intended to be educational and may be different from the terms and definitions in your plan. With indemnity, you will pay an upfront deductible before there is any reimbursement by the insurance company. Glossary of medical insurance terminology page 1 annual deductible is the amount you must pay each year for medical and mental health expenses before your medical plan begins to pay benefits. The health insurance or plan pays the rest of the allowed amount. It is paired with a health reimbursement account hra that covers much of the deductible associated with routine medical expenses.
Glossary of commonly used healthcare terms 340b program. The federal poverty level fpl is the set minimum amount of. Property insurance provides coverage for property that is stolen, damaged, or destroyed by a covered peril. It serves as an introduction to health insurance from the point of view of consumers under the age of 65 who purchase a health insurance plan. These glossary erms and definitions are intended to be educational and may be different from the terms and definitions in your plan. Health insurance glossary page access your availability to medical care which is determined by where you live and the type of health care facilities available in your area accident for the purposes of health insurance, an accident is an unforeseen, unexpected and unintended event resulting in a bodily injury. The insurance contracts act allows an insurer to avoid. A guide to dental ppos, hmos and other managed plans, don mayes, revised edition, 2002. In the united states, this level is determined by the department of health and human services. Word description ten day free look a notice on the first page of health insurance policies that the insured has ten days in which to examine the policy and return it for a refund of premium if he is not satisfied with the policy. This glossary is intended for educational purposes and may differ from the terms used in your insurance planpolicy.
If your plan has a 20% coinsurance, your insurance may pay 80% of the cost and you might pay 20%. Health insurance glossary and key terms health insurance policies can get confusing fast. Glossary of commercial insurance terms commercial insurance is divided into two main categories. Health insurance portability and accountability act of 1996 hipaa health maintenance organization hmo health reimbursement arrangement hra health savings account hsa highdeductible health plan hdhp indemnity health plan. Below are definitions for some of the more commonly used terms and how.
Accumulation period the period of time during which the policy holder. Any activity done to help a person or group get something the person or group wants or needs. When making decisions about health coverage, consumers should know the specific meanings of terms used to discuss health insurance. Health insurance glossary of terms admitting privileges. But once you meet your outofpocket maximum, your insurance pays 100% of qualifying costs. Glossary of health coverage and medical terms omb control numbers 15452229, 12100147, and 09381146 page 1 of 6 glossary of health coverage and medical terms this glossary defines many commonly used terms, but isnt a full list.
Together, we created this glossary of key health insurance terms. Private health insurance the term health insurance covers a wide range of policies that cover the costs of doctors and hospitals and those that meet specific needs, such as paying for longterm care. Adjusted community rating means that the rates charged by insurance companies may vary by one or more variables such as age, gender, or health status. Glossary of health coverage and medical terms page 1 of 4 this glossary has many commonly used terms, but isnt a full list. 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. Advice advice is defined as any consultation regarding symptoms or abnormalities that you have received from a general practitioner gp, therapist, or other healthcare specialist. Health insurance glossary health insurance definitions. Moreover, we need to force the healthy to get health insurance or let insurer charge di erently for the sick from the healthy. Street address heer hall, 635 loop road, kent, oh, 44242 mailing address po box 5190 kent, oh 442420001. Health insurance glossary health insurance private. Those can be found in your insurance policy or certificate. This is the share of the cost you pay for health care received after you meet your deductible. We want you to use it often, so you can become familiar with some of the words youll hear when you get medical.
Health insurance glossary terms hawaii department of. Maximum amount paid per year for specific or total medical services. Glossary of dental insurance and dental care terms. This glossary defines commonly used health insurance and health care terms. Health services provided to members who are not confirmed to a health care institution. Health insurance terminology types of medical plans consumer driven health cdh this is a high deductible health insurance plan with lower premiums than a traditional lowdeductible ppo. Weve put together this helpful glossary to explain the terms you may come across when buying private medical insurance pmi. An individual plan can cover you andor any of your eligible family members. Serving maryland, the district of columbia and portions of virginia, carefirst bluecross blueshield is the shared business name of carefirst of maryland, inc.
Check out our health insurance glossary full of information and terms commonly used in the health industry. The insurance plan year is the 12month period when your insurance company provides your health care benefits and also the. The amount plan members pay outofpocket for medical services. To view pdf files on this website you need the free adobe reader. Health insurance glossary carefirst bluecross blueshield.
Some health insurance companies may use some words with a diffferent meaning from those given in this health insurance glossary, and practices may vary among health insurance companies since a health insurance glossary can only be general in nature, you. This health insurance glossary is not exhaustive and may not be accurate because usage of terms can vary. This website and the information contained, expressed or implied herein are made available solely for general informational purposes and are not intended to be legal, tax, health, medical or professional advice or the sole source of information about health insurance coverage or specific health plans. Amount payable by the insurance company to a claimant, assignee, or beneficiary when the insured suffers a loss. Glossary of health insurance and medical terms this glossary has many commonly used terms, but it isnt a full list. The type of health insurance in which we are usually interested is.
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