Glossary
A
- Abortion services
- Accountable care organization
- Accreditation
- Actuarial value
- Adjusted Gross Income (AGI)
- Advance premium tax credit (APTC)
- Affordability exemption
- Affordable Care Act (ACA)
- Affordable coverage
- Agent and broker (health insurance)
- Alimony
- Allowed amount
- Annual deductible combined
- Annual limit
- Appeal
- Application ID
- Attest/Attestation
- Authorized representative
B
C
- Cafeteria plan
- Canceled debts
- Capital gains
- Care coordination
- Catastrophic health plan
- Centers for Medicare & Medicaid Services (CMS)
- Certified application counselor
- Children's Health Insurance Program (CHIP)
- Chronic disease management
- Claim
- Co-op
- COBRA
- Coinsurance
- Community rating
- Competitive bidding
- Complication of pregnancy
- Conversion
- Coordination of benefits
- Copayment
- Cost sharing
- Cost sharing reduction (CSR)
- Court awards
- Creditable coverage
D
E
- Early and Periodic Screening, Diagnostic, and Treatment Services (EPSDT)
- Eligibility assessment
- Eligible immigration status
- Emergency medical condition
- Emergency medical transportation
- Emergency room care
- Emergency services
- Employer or union retiree plans
- Employer shared responsibility payment (ESRP)
- Essential health benefits
- Exchange
- Excluded services
- Exclusive Provider Organization (EPO) Plan
- Exemption
- Exemption Certificate Number (ECN)
- External review
F
G
H
- Habilitative/Habilitation services
- Hardship exemption
- Health care workforce incentive
- Health coverage
- Health insurance
- Health Insurance Marketplace®
- Health Maintenance Organization (HMO)
- Health plan categories
- Health Reimbursement Arrangement (HRA)
- Health Savings Account (HSA)
- Health status
- High Deductible Health Plan (HDHP)
- High-cost excise tax
- High-risk pool plan (state)
- HIPAA eligible individual
- Home and community-based services (HCBS)
- Home health care
- Hospice services
- Hospital outpatient care
- Hospital readmissions
- Hospitalization
- Household
I
M
- Marketplace
- Medicaid
- Medical loss ratio (MLR)
- Medical underwriting
- Medically necessary
- Medicare
- Medicare Advantage (Medicare Part C)
- Medicare hospital insurance tax
- Medicare Part D
- Medicare prescription drug donut hole
- Member survey results
- Minimum essential coverage (MEC)
- Minimum value
- Modified Adjusted Gross Income (MAGI)
- Multi-employer plan
- Multi-state plan
N
O
P
- Patient Protection and Affordable Care Act
- Patient-centered outcomes research
- Payment bundling
- Penalty
- Pension (retirement benefit)
- Physician services
- Plan
- Plan ID
- Plan year
- Platinum health plan
- Point of Service (POS) Plans
- Policy year
- Pre-existing condition
- Pre-existing condition (job-based coverage)
- Pre-existing condition exclusion period (individual policy)
- Pre-existing condition exclusion period (job-based coverage)
- Pre-existing Condition Insurance Plan (PCIP)
- Preauthorization
- Preferred provider
- Preferred Provider Organization (PPO)
- Premium
- Premium tax credit
- Prescription drug coverage
- Prescription drugs
- Prevention
- Preventive services
- Primary care
- Primary care physician
- Primary care provider
- Prior authorization
- Public health
Q
R
S
- Same-sex marriage
- Second lowest cost Silver plan (SLCSP)
- Self-employment income
- Self-employment ledger
- Self-insured plan
- Service area
- Silver health plan
- Skilled nursing care
- Skilled nursing facility care
- Small Business Health Options Program (SHOP)
- Social Security
- Social Security benefits
- Social Security survivors benefits
- Special Enrollment Period (SEP)
- Special health care need
- Specialist
- Spousal abandonment
- Stand-alone dental plan
- State continuation coverage
- State Health Insurance Assistance Program (SHIP)
- State insurance department
- State medical assistance office
- Subsidized coverage
- Summary of Benefits and Coverage (SBC)
- Supplemental Security Income (SSI)