Although there are standard terms that are used in every policy of health insurance, each health insurance policy has its own definition of those standard terms. Understanding health care can be difficult when insurers and the medical industry use a lot of specialized language. Glossary of commonly used healthcare acronyms and terms. The term insurance solicitor as used in this act means a life insurance solicitor, a nonlife insurance solicitor, or a small amount and short term insurance solicitor. Health maintenance organization hmo a medical group plan that provides physician, hospital, and clinical services to participating members in exchange for a.
Allowed amount the highest amount we will cover pay for a service. What is comprehensive community medical and health care. 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. A comprehensive consumer guide to individual health insurance and coverage options, featuring expert analysis plus plan shopping and enrollment tools. February 14, 2015 by echiropractor guest heath insurance terminology can be very confusing. Your share of the costs of a covered healthcare service, calculated as a fixed percentage. Consumer glossary national association of insurance. Health insurance can reimburse the insured for expenses incurred from illness. This handbook is revised based on handbook of medical and dental terminology for international medical. Each health insurance policy is different, be sure and check the terms in your contract.
For example, gerber life customer service representatives can help you to understand basic insurance terminology, decide how much life insurance you need and can afford, find out how to choose the best kind of policy for you, and assist you in other ways. Health insurance terminology quiz 1 flashcards quizlet. Insurance glossary understanding common insurance terms this glossary provides insurance terms definition and explanation commonly used in insurance business world. Learn vocabulary, terms, and more with flashcards, games, and other study tools. If youre familiar with the common industry insurance terms youll be better equipped to negotiate for the best renters insurance coverage actual cash value acv present property cash value. Kim do hoon health insurance policy research institute, national health insurance service, korea, mr. Additional terms are available through the glossary page. The charges agreed to by the preferred provider organization ppo for specified covered medical treatment, services and supplies.
In such case, the term laws and regulations relevant to labor insurance in. It is important to understand these definitions when choosing a policy or understanding coverage. This document contains a list of commonly used health insurance terms and their definitions to help consumers better understand how health insurance coverage works. Bodily injury means any accidental physical bodily harm solely and directly caused by external, violent and. Glossary of healthcare terms health insurance and reform accountable care organization aco. Ronen bensimon, 28, also eating lunch in minneapolis, says some basic health insurance terms are lost on him even though hes a nurse. A number of references were used in developing the definitions below. A trusted independent health insurance guide since 1994. The most you pay during a policy period usually a year before your health insurance or plan begins to pay 100% of the allowed amount. Some of these words are common with many types of insurance. Health insurance terminology download ebook pdf, epub.
National health insurance service, korea on july 9th 2014, mr. Health insurance is a type of insurance coverage that pays for medical and surgical expenses incurred by the insured. 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. Get a free online adult life insurance quote or call us at 18007042180 to get started. It also has a precise definition under the health insurance portability and accountability act of 1996 that exempts from certain requirements insurers that sell insurance to small employers only through. Short term health insurance temporary coverage health. Understanding health insurance terms, medical insurance usa.
Health insurance glossary health insurance definitions and. A group of health care providers who give coordinated care, chronic disease management, and thereby improve the quality of patient care. A type of health insurance plan that, compared to traditional health insurance plans, requires greater outofpocket spending, although premiums may be lower. Oct 31, 2019 a health insurance grace period is the amount of time an insurance company will give a policyholder to pay their health insurance premium after the due date before insurance coverage would be canceled or considered null and void. This limit never includes your premium, balancebilled charges or health care. This list defines many common healthcare terms you might not know.
Shortterm insurance a type of health insurance that covers certain services for a set time period 6 months or less. These glossary terms and definitionsare intended to be educational and may be different from the terms and definitions in your plan. 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. Department of health and human services hhs dependent coverage.
Are you new to health insurance or just want a better understanding of how it works. Health insurance and medical terms bowling green state. Out of pocket maximum the most you will have to pay for covered medical expenses in a plan year through deductible and coinsurance before your insurance plan begins to pay 100 percent of covered medical expenses. Youll need to refer to your own policy for specific definitions of these terms, but this terminology is what concerns insure people the most. A glossary to help you understand common health insurance terms and medical insurance terminology in usa coinsurance the amount you are required to pay for medical care in a feeforservice health plan after you have met your deductible. Compare plans side by side, get health insurance quotes, apply online and find affordable health insurance today. On march 23, 2010, president obama signed the patient protection and affordable care act ppaca into law. Glossary of commonly used healthcare terms 340b program. 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. The payment of health insurance benefits to a healthcare provider rather than directly to the member of a health insurance plan. Health insurance glossary health insurance definitions.
Medicare summary notice for part b medical insurance pdf, 415 kb. It is called 340b since that is the section of the public health service act that establishes the program. This section of our website can help you learn everything you need to know, from common terms and acronyms to how to budget for and select the right health plan for you and your family. These are a few of the most common terms youll encounter in health care and insurance. Start studying health insurance terminology quiz 1. Oct 23, 2019 health insurance is a type of insurance coverage that pays for medical and surgical expenses incurred by the insured.
The health insurance deductible definition, quite simply, is the amount of money the insurance company. Byeon, jinsu, general manager, national health insurance service, korea visited ipss. Glossary of health coverage and medical terms this glossary defines many commonly used terms, butisnt a full list. Urgent care provider a provider of services for health problems that need medical help right away but are not emergency medical conditions. Written in technical terms, this book is very difficult to understand. The amount you pay for covered health care services before your insurance plan starts to pay. Below are definitions for some of the more commonly used terms and how. The health insurance deductible definition, quite simply, is the amount of money the insurance company requires the subscriber to pay before the health insurance starts to pay claims.
A health insurance grace period is the amount of time an insurance company will give a policyholder to pay their health insurance premium after the due date before insurance coverage would be canceled or considered null and void. I dont even know what coinsurance is, to be honest. When making decisions about health coverage, consumers should know the specific meanings of terms used to discuss health insurance. Plans in the marketplace are primarily separated into 4 health plan categories bronze, silver, gold, or platinum based on the percentage the plan pays of the average overall cost. Glossary of health coverage and medical terms page 1 of 4 this glossary has many commonly used terms, but isnt a full list. A deductible is a costsharing requirement under a health insurance policy that provides that the insurer will not be liable for a specified rupee amount in case of indemnity policies and for a specified number of dayshours in case of hospital cash policies which will apply before any benefits are payable by the insurer. This site is like a library, use search box in the widget to get ebook that you want.
Webmd provides definitions of terms related to health insurance, the affordable care act and medicare. Knowing these terms can help you choose a plan that meets your needs. Click download or read online button to get health insurance terminology book now. Durable medical equipment dme early and periodic screening, diagnostic, and treatment services epsdt eligibility assessment. Definition of comprehensive community medical and health care. Documentation of the head of households bank account information. 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. The money the insurance company pays the health care provider for medical services provided to you if you become ill or injured. Association health plans this term is sometimes used loosely to refer to any health plan sponsored by an association.
The 340b drug pricing program enables eligible health care organizations known as covered entities to purchase drugs from manufacturers at reduced prices. Chapter vii federation of national health insurance associations articles 83 to 86. Jun 25, 20 understanding health care can be difficult when insurers and the medical industry use a lot of specialized language. Accident accident means an unexpected, unforeseen and undesirable event, especially one resulting in bodily injury. Oct 14, 2014 for example, gerber life customer service representatives can help you to understand basic insurance terminology, decide how much life insurance you need and can afford, find out how to choose the best kind of policy for you, and assist you in other ways. Insurance glossary understanding common insurance terms. With short term health insurance plans you will often see a much lower premium than obamacare, but they do not include all of the ten essential health benefits associated with aca plans. Glossary of healthcare terms health insurance and reform. I have no obligation to open a health insurance plan.
Standard definitions of terminology used in health insurance policies. Short term health insurance plans typically last less than a year varying by state and offer the core benefits expected of a traditional health plan. Life insurance terminology gerber life insurance parenting blog. Jun, 2015 although there are standard terms that are used in every policy of health insurance, each health insurance policy has its own definition of those standard terms. Outofnetwork copayments usually are more than innetwork copayments.
A contract that requires your health insurer to pay some or all of your health care costs in exchange for a premium. Members can take a free confidential hearing test by phone. A physicians assessment of a patients state of health as outlined in office notes and test results compiled by the physician. Medicare supplement insurance 11575j pdf, 264 kb revised may 2019. A specified amount you pay before your insurance will start paying towards your medical expense.
1227 669 342 1664 664 128 1080 225 272 570 602 243 460 1322 796 147 22 582 1094 411 310 1005 1105 46 703 307 1349 571 783 15 287 1220 1029 543 432 998 467