A complaint that you communicate to your health insurer or plan. 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. A provider network is a collection of providers, hospitals and facilities that have agreed to set reimbursement rates for health care services delivered to members of a health insurance plan. 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. If your plan has a 20% coinsurance, your insurance may pay 80% of the cost and you might pay 20%. The ability of a doctor to admit a patient to a particular hospital. 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. A company owned solely or in large part by one or more non insurance entities for the primary purpose of providing insurance. This page provides a glossary of insurance terms and definitions that are commonly used in the insurance business. 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. A company owned solely or in large part by one or more non insurance entities.
An individual plan can cover you andor any of your eligible family members. Health insurance glossary understanding health care. 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. Make sure you take a look at what you need your health insurance to do for you and compare it to the benefits provided through short term medical. On march 23, 2010, president obama signed the patient protection and affordable care act ppaca into law. Uniform glossary health insurance plans for individuals. When making decisions about health coverage, consumers should know the specific meanings of terms used to. The plan must also limit the total amount of outofpocket cost. An independent agent represents more than one company. Glossary of healthcare terms health insurance and reform accountable care organization aco. You can get a copy of the policy at or you may call. The definitions in this glossary are developed by the naic research and actuarial department staff based on various insurance references.
The buildup of calcium deposits in soft tissue, causing it to harden. Items and services that are covered by your insurance plan. Health insurance reimburses the costs of necessary medical treatment in the event. 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. 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. Sum insured the maximum amount indicated in insurance contract that the health of each insured is insured for, and which is the maximum amount to be paid out as insurance indemnity upon occurrence of an insurable event. But once you meet your outofpocket maximum, your insurance pays 100% of qualifying costs. It is a way to distribute the financial risk associated with the variation of individuals health care expenditures by pooling costs over time prepayment and over people. Glossary of risk management terms this is a comprehensive list of insurance terms. In the united states, this level is determined by the department of health and human services. A federal and statefunded health insurance program for.
Some of these terms also might not have exactly the same meaning. Glossary of health coverage and medical terms this glossary defines many commonly used terms, butisnt a full list. If you should have any questions or would like to see a specific term added, please contact us. A glossary pdf,, download ebookee alternative excellent tips for a improve ebook reading.
Compare plans side by side, get health insurance quotes, apply online and find affordable health insurance today. Missouri department of health and senior services bureau of special health care needs family partnership health insurance glossary of terms admitting privileges. Glossary of commonly used healthcare terms 340b program. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. These glossary terms and definitions are intended to be educational and may be different from the terms and definitions in. These glossary terms and definitionsare intended to be educational and may be different from the terms and definitions in your plan. Liability arising from extremely dangerous operations. We have had people ask for a place to quickly look up certain health insurance terms. Glossary of health insurance and medical terms this glossary has many commonly used terms, but it isnt a full list. The 340b drug pricing program enables eligible health care organizations known as covered entities to purchase drugs from manufacturers at reduced prices.
The uniform glossary includes many commonly used health coverage and medical terms, but isnt a. Glossary of health coverage and medical terms page 1 of 4 this glossary has many commonly used terms, but isnt a full list. While it covers some medical expenses, it doesnt cover everything. In comparing and evaluating health plan options, the industry terminology can be a little overwhelming. The federal poverty level fpl is the set minimum amount of. The discontinuance of an insurance policy before its normal expiration date, either by the insured or the company. This category includes diseases that are usually transmitted through persontoperson. Not all concepts or coverages identified in this list are found at chapman university. Ambulatory services health services provided to members who are not confined to a health care institution.
Here you will find bilingual glossaries on insurance, workplace health and safety osha and other work related topics. Religare health insurance reserves the right to change the terms, conditions and notices under which the sites are offered, including but not limited to the charges, if any, associated with the use of the sites. Surgery to improve blood flow to the heart by diverting blood around a blocked artery. These glossary terms and definitions are intended to be educational and may be different from the terms and definitions in your plan. Insurance terminology north american training group. The federally facilitated marketplaces are just one place where people can compare plans. Find understandable and helpful definitions for common health insurance and healthcare terms in medical mutuals health insurance glossary. Providence health plan has three networks that are matched to our various plans. Consumer glossary national association of insurance. Glossary of health coverage and medical terms university.
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. Glossary of health insurance terms health insurance for. This glossary defines commonly used health insurance and health care terms. 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. See if you qualify for a special enrollment period. Get a free online adult life insurance quote or call us at 18007042180 to get started. The patient protection and affordable care act enables more americans to have access to quality, affordable health insurance. Health care services that help a person keep, learn or. Glossary of commonly used healthcare acronyms and terms. Glossary of healthcare terms health insurance and reform. Instead of, or in addition to, paying a fixed amount up front a copayment or deductible, the co insurance is a percentage of the total cost that insured person may also pay. Health care services that your health insurance or plan doesnt pay for or cover.
Glossary and abbreviations quality health insurance. Oregon health authority page 3 public health terminology training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation or care. Some people can get health insurance through a group health plan offered by their employer or their spouses employer. Longterm insurance a type of health insurance that covers certain services over a set amount of time.
A group of health care providers who give coordinated care, chronic disease management, and thereby improve the quality of patient care. The maximum amount of benefits a health insurance plan will pay over a persons lifetime. Health insurance terms university of south florida. The insurance products taken out for you are shown in your insurance policy which you receive from your insurance broker. Any activity done to help a person or group get something the person or group wants or needs. Often seen in breast tissue by mammography or in coronary arteries by xray or cardiac ct scans. 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 cover including the sums insured and rules on deductibles is definitively described in the terms and conditions of insurance. Those can be found in your insurance policy or certificate. A health plan with a higher deductible often has a lower premium, which is the amount you pay each month to have insurance. Agent the insurance company representative who sells policies on behalf of the insurer. Other terms and more information are in your insurance policy or certificate. Short term medical insurance, as its name implies, isnt meant to be a longterm solution. Glossary of health coverage and medical terms page 1 of 4 glossary of health coverage and medical terms xthis glossary has many commonly used terms, but isnt a full list. Health insurance glossary health insurance definitions. This glossary is intended for educational purposes and may differ from the terms used in your insurance planpolicy.
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