Health insurance and obamacare terms what does health reform mean to you. These glossary terms and definitions are glossary of health coverage and medical. The discontinuance of an insurance policy before its normal expiration date, either by the insured or the company. Glossary of health coverage and medical terms this glossary defines many commonly used terms, butisnt a full list. The main purpose of the dictionary is to strengthen the means of communication between spanish speaking populations and the health workers serving. Glossary of health insurance terms health insurance for.
Actual cash value is the fair market value of your vehicle. If you qualify for a tax credit or subsidy to help pay for your coverage, you must buy your health plan through the federal health insurance marketplace, located at healthcare. A company owned solely or in large part by one or more non insurance entities. If you come across a term youre not sure about, check the glossary at the back of the book. May 26, 2018 medical insurance glossary of terms 2018. Health insurance portability and accountability act of 1996 hipaa the administrative simplification provisions of the health insurance portability and accountability act of 1996 hipaa, title ii required the department of health and human services hhs to establish national standards for electronic health care transactions and national. 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.
Other terms and more information are in your insurance policy or certificate. This document contains a list of commonly used health insurance terms and their definitions to help consumers better understand how health insurance coverage works. Glossary of health coverage and medical terms university benefits glossary of health coverage and medical terms glossary of health coverage and medical terms skip to main content. 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. The maximum amount of benefits a health insurance plan will pay over a persons lifetime.
If you have any questions about the use or meaning of a term or expression in any particular product or literature, you. Glossary of health insurance terms as you explore our site, you may come across an unfamiliar word or term. Some of these terms also might not have exactly the same meaning when medicare basics. Durable medical equipment dme early and periodic screening, diagnostic, and treatment services epsdt eligibility assessment. Insurance terminology north american training group.
Definitions of health insurance terms in february 2002, the federal governments interdepartmental committee on employmentbased health insurance surveys approved the following set of definitions for use in federal surveys collecting employerbased health insurance data. Jan 07, 2014 this document contains a list of commonly used health insurance terms and their definitions to help consumers better understand how health insurance coverage works. A form of corporation, allowed by the irs for most companies with 35 or fewer shareholders, which enables the company to enjoy the benefits of incorporation but be taxed as if. Also called an exchange, a health insurance marketplace is a place where you can buy health coverage online. Medical insurance glossary of terms 2018 health medicare pdfs. Understand all of the health insurance terms that are important to know throughout the enrollment process. Nov 01, 2017 when it comes to choosing the best automobile insurance, knowing industry terms and language gives you a good head start. Most had little or no experience with health insurance terminology.
This az pocket guide to understanding financial terms is just one of the achievements of ebss partnership with nala. Some of these terms also might not have exactly the same meaning. Health coverage and medical terms gtm payroll services. Glossary of insurance terms this list is not meant to be all inclusive, but should help with your understanding some insurance terms used in our website. These glossary terms and definitions are intended to be educational and may be different from the. On march 23, 2010, president obama signed the patient protection and affordable care act ppaca into law. The guide is an important resource that will help to create a much greater understanding of. 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. 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. Health care services that your health insurance or plan doesnt pay for or cover. Broker a licensed professional who helps businesses and individuals obtain a health plan.
The federal poverty level fpl is the set minimum amount of. Coinsurance a form of medical cost sharing in a health insurance plan that requires an insured person to pay a. This glossary has many commonly used insurance and medical terms, but isnt a full list. Glossary of health insurance terms by rmhp in comparing and evaluating health plan options, the industry terminology can be a little overwhelming. These glossary terms and definitions are intended to be educational and may be different from the terms and definitions in your plan. Claim a statement that includes the health care services you have received and what the services cost. Some health insurance or plans dont coun t all of your copayments, deductibles, coinsurance payments, out ofnetwork payments or other expenses. Glossary of health insurance and medical terms this glossary has many commonly used terms, but it isnt a full list. Maryland health connection marylands official health insurance marketplace. Glossary of health insurance terms national health policy forum.
These general definitions are provided for educational purposes. You can get a copy of the policy at or you may call. 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 policy. Some terms may have multiple and varying definitions based on the context and primary source of authority. This glossary has many commonly used terms, but isnt a full list. Glossary of health coverage and medical terms university. If your plan has a 20% coinsurance, your insurance may pay 80% of the cost and you might pay 20%.
Insurance definitions, dictionary, glossary and terms. Health insurance glossary health insurance definitions and. After paying 80 percent of losses up to a specified ceiling, the insurer starts paying 100 percent of losses. On march 23, 2010, president obama signed the patient protection and affordable care act ppaca into. If you have any questions about the use or meaning of a term or expression in any particular product or literature, you should raise them with the provider concerned. World health organization, regional office for europe, 1998. Medical insurance glossary of terms health medicare pdfs.
Glossary of health coverage and medical terms this glossary defines many commonly used terms, but isnt a full list. This glossary is intended as a general aid to help you understand some of the commonly occurring phrases and jargon used in the insurance world. 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. This is the share of the cost you pay for health care received after you meet your deductible. But once you meet your out of pocket maximum, your insurance pays 100% of qualifying costs. Glossary of insurance policy terms the oecd has produced a unique glossary of insurance policy terms which covers selected topics ranging from insurance policy regulationsupervision to general trade issues.
Every industry has its own jargon, and the health and life insurance business is no exception. The international shipping and marine transport industry is full of unique shipping terms and shipping abbreviations. Weve curated a list of life and health insurance terms and their definitions to help you better understand the confusing language of insurance. Health insurance a contract that requires your health insurance company to pay some or all of your health care costs in exchange for a premium. Words associated with surety and bonds and title insurance are listed separately at the end of this list. These definitions do not alter or modify the terms of any insurance contract. A complaint that you communicate to your health insurer or plan.
This page provides a glossary of insurance terms and definitions that are commonly used in the insurance business. Some of these terms also might not have exactly the same meaning when. Having launched it originally in 2004 we have now updated it with modern terminology to meet with the increasing demand for the book. The following glossary is intended to be educational and may be different from the terms and definitions in your own insurance plan. To help you better understand health insurance, heres a list of the most commonly used health care terms and definitions. Policy documents contain a number of insurance terms because they typically define the limitations of risk and liability on the insured and any exclusions of coverage. A glossary of technical terms on the economics and finance of health services. Those can be found in your insurance policy or certificate.
When reading the definitions, please keep in mind that this glossary is provided as a guide only curated from various sources. Mcqa glossary of terms texas department of insurance. If there is any conflict between these definitions and the provisions of the. A company owned solely or in large part by one or more non insurance entities for the primary purpose of providing insurance. For example, if a health care service is covered at a 20 percent coinsurance, you would pay 20 percent of the covered costs, and the plan would pay 80 percent. Health maintenance organization hmo a type of health benefit plan that usually limits coverage to care from doctors who work for or contract with the hmo. See page 4 of the pdf download for an example showing how deductibles, coinsurance and outofpocket limits work together in a real life situation. These glossary terms and definitionsare intended to be educational and may be different from the terms and definitions in your plan. Ambulatory services health services provided to members who are not confined to a health care institution. These glossary terms and definitions are intended to be educational and may be different from the terms and definitions in. 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. Access a patients ability to obtain medical care determined by factors such as the availability of medical services, their acceptability to the patient, the location of. Weve developed a glossary of health care terms we hope will help you.
Prioritization, costing and the medium term time horizon, world health organization, western pacific regional office, undated. Health care terminology glossary aaahcc american accreditation health care commission aahcc accreditation is an important quality seal of approval for provider networks and managed care organizations. For health insurance, it is a percentage of each claim above the deductible paid by the policyholder. The following is glossary of health benefit terms that are often used during open enrollment benefits season. A federal and statefunded health insurance program for lowincome children, elderly, blind or disabled people. The plan must also limit the total amount of out of pocket cost. When making decisions about health coverage, consumers should know the specific meanings of terms used to. Download glossary of insurance and risk management terms.
Glossary of health insurance terms health insurance for employers. Health insurance is full of terms you may not know. 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 definitions are intended to be educational and may be different from the terms. The definitions in this glossary are developed by the naic research and actuarial department staff based on various insurance references. A comprehensive law passed in 2010, aimed at reforming americas health care system to improve access and affordability for more americans. Consumer glossary national association of insurance. Department of health and human services hhs dependent coverage.
Our insurance terms glossary is divided alphabetically by insurance terms in a quick reference guide to assist understanding the language commonly used by insurance companies. Webmd provides definitions of terms related to health insurance, the affordable care act and medicare. Health insurance glossary texas department of insurance. Carrier another term for an insurer or insurance company. Health insurance glossary understanding health care terms. Aarp health insurance plans pdf download medicare replacement pdf download aarp medicarerx plans united healthcare pdf download. Insurance glossary understanding common insurance terms. For a 20 percent health insurance coinsurance clause, the policyholder pays for the deductible plus 20 percent of his covered losses. 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. Health care services that help a person keep, learn or. Glossary of health coverage and medical terms just plain clear.
Its what you could expect to receive if you sold your car to a private buyer, and its what an insurer will base your payment on if your car is stolen or totaled. Glossary of health insurance terms blue cross and blue shield of. Bold text indicates a term defined in this glossary. With the recent changes to health care laws and insurance procedures, there are many terms and phrases that may be unfamiliar. A form of insurance that pays damages equal to the replacement value of damaged property minus.
An independent agent represents more than one company. Different insurance providers may have varying ideas about what constitutes full coverage, but it will always include the insurance legally required by your state. Health care terminology glossaryaaahcc american accreditation health care commission aahcc accreditation is an important quality seal of approval. Agent the insurance company representative who sells policies on behalf of the insurer. Glossary of health coverage and medical terms page 1 of 4 this glossary has many commonly used terms, but isnt a full list. Pdf knowledge of health insurance terminology and details. A comprehensive law passed in 2010, aimed at reforming americas health care system.
Please read your official policy for full details about coverages. If youre looking for a free download links of glossary of insurance and risk management terms pdf, epub, docx and torrent then this site is not for you. Glossary of health coverage and medical terms this glossary has many commonly used terms, but isnt a full list. Glossary of health insurance terms cchp health plan. Glossary of health insurance terms blue cross and blue. With this publication, the qtmhc has endeavoured to develop a practical resource to enhance the skills of interpreters who do not have access to mental health training and for those working in regional settings. Military health system mhs health care glossary serves as the official repository and consolidated reference as a secondary source for terms and definitions used within the mhs. And these are used every day to describe everything from modes of transport, units of measure, pricing structures, incoterms and much more. In the united states, this level is determined by the department of health and human services. Medical insurance glossary of terms 2018 health medicare. Please refer to your policy or certificate of insurance for exact definitions of terms and coverage provisions.
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