Basics Of Health Insurance Vocabulary Review

Basic medical expense policy - Health insurance policy that provides first dollar benefits for specified and limited health care such as hospitalization surgery or physician services. It stands for the Consolidated Omnibus Budget Reconciliation Act of 1985 which is the law that first introduced COBRA insurance.

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A federally and state-sponsored health insurance programs for the medically indigent.

Basics of health insurance vocabulary review. Many of the terms you encounter when dealing with health insurance are not familiar. Like auto insurance covers your car if you get into an accident health insurance covers you if you get sick or injured. Health Maintenance Organization HMO - a medical group plan that provides physician hospital and clinical services to participating members in exchange for a periodic flat fee.

Medical Care - Medical services received from a healthcare provider or facility to treat a condition. Take insurance quiz questions and answers to test your knowledge on Basics of Insurance for Beginners module. Learning to express yourself in English when talking about your health can be difficult.

The process by which a patient or provider attempts to persuade an insurance payer to pay for more or in certain cases pay for any of a medical claim. A federally sponsored health insurance program for those over 65 years or disabled individuals under 65 years old b. Medicare The federal program established to provide health care coverage for eligible senior citizens and certain eligible disabled persons under age 65.

That are spent by the insurance company on health care services. PPACA requires that large group plans spend 85 of premiums on clinical services and other activities for the quality of care for enrollees. 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.

Here you will find some key insurance terms and definitions. While these terms can be confusing the better you understand them the better you will be prepared to successfully gain coverage and access to the treatments that are right for you. Health insurance plans typically include a deductible or co-payment for services.

Health insurance or plan that helps pay for prescription drugs and medications. A licensed health care facility program agency doctor or health professional that contracts with a health plan to deliver health care services to plan members. Deductibles may differ depending on the service performed.

While you dont need to understand the more technical scientific or medical language doctors and other healthcare providers use it is helpful to know basic health-related vocabularyThis page provides some of the most common English vocabulary used to talk about health and healthcare. A term sometimes applied to private insurance products that supplement Medicare insurance. Coinsurance - A form of medical cost sharing in a health insurance plan that requires an insured person to pay a stated percentage of medical expenses after the deductible amount if any was paid.

The percentage of health insurance. A health insurance program that offers eligible employees and their dependents extended health insurance coverage for the plan theyre on in the event that they lose their job or their hours are reduced. You andor your employer usually pay it monthly quarterly or yearly.

An organization that contracts with the government to handle and mediate insurance claims from medical facilities home health agencies or providers of medical services or supplies. Plans must devote 80 of premiums to these purposes. This is the amount you will pay out-of-pocket for services before the insurance coverage pays.

This is a quiz for your Insurance mastery. The amount that must be paid for your health insurance or plan. WebMD provides definitions of terms related to health insurance the Affordable Care Act and Medicare.

Characterized by limited benefit periods and relatively low coverage limits. Health insurance is a product that covers your medical expenses. One should have the knowledge of risk and how to mitigate or cover the risk is very important for well-being and lack of these knowledge can invite financial troubles in your personal life.

Once any deductible amount and coinsurance are paid the insurer is responsible. Preferred Provider Organization PPO plana health insurance plan that offers greater freedom of choice than HMO health maintenance organization plans. Pre-existing conditiona health problem that has been diagnosed or for which you have been treated before buying a health insurance plan.

The Affordable Care Act Obamacare guarantees basic health insurance by making sure plans provide minimum essential coverage sometimes called qualifying health coverage This is any insurance plan that meets the Affordable Care Act requirement for health coverage. Speaking the language also helps avoid misunderstandings and minimize extra steps or back-and-forth with your insurance company. The appeal on a claim only occurs after a claim has either been denied or rejected See Rejected Claim and Denied Claim.

Drugs and medications that by law require a prescription. Customers with PPOs are free to receive care from both in-network or out-of-network non-preferred providers but will receive the highest level of benefits when they use providers inside the network. Entitlement program or healthcare plans sponsored andor subsidized by the state or federal government.

Long-term Insurance - A type of health insurance that covers certain services over a set amount of time typically a 12-month period. Prescription Drug Coverage UCR. Health insurance also covers preventive care ie doctors visits and tests before you get sick.

This is common in self-insured health care plans.

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