Glossary
Tags
- ACA
- ACA Marketplace
- ACA subsidies
- CHIP
- CMS
- ESRD
- Extra Help
- FMAP
- FPL
- FQHC
- FSA
- HCBS
- HMO
- HRA
- HSA
- IEP
- IRMAA
- Joint Commision
- KFF
- LCD
- LIS
- Marketplace
- Medicaid
- Medicaid (rare)
- Medicaid expansion
- Medicare
- Medicare Advantage
- Medicare Part A
- Medicare Part B
- Medicare Part D
- Medicare coordination
- Medigap
- NCD
- NEMT
- NOMNC
- Original Medicare
- PCP
- Part A
- Part B
- Part C
- Part D
- QLE
- QMB
- SEP
- SNF
- SNP
- SSI
- Section 1115
- Silver Plan
- Silver plan
Catastrophic Health Plan
A low-premium, high-deductible health insurance plan available under the ACA Marketplace, primarily covering major medical expenses. Catastrophic plans are available to people under 30 or those with a hardship exemption.
A low-premium, high-deductible health insurance plan available under the ACA Marketplace, primarily covering major medical expenses. Catastrophic plans are available to people under 30 or those with a hardship exemption.
Gold Plan (ACA)
A health insurance plan offered through the ACA Marketplace that covers approximately 80% of healthcare costs, with the remaining 20% paid by the enrollee. Gold plans have higher premiums but lower out-of-pocket costs compared to Bronze and Silver plans.
A health insurance plan offered through the ACA Marketplace that covers approximately 80% of healthcare costs, with the remaining 20% paid by the enrollee. Gold plans have higher premiums but lower out-of-pocket costs compared to Bronze and Silver plans.
Grace Period
The extra time given to policyholders to pay their health insurance premiums after the due date. During the grace period, coverage continues, but failure to pay by the end of the grace period may result in termination of coverage. This applies to ACA, Medicare, and Medicaid plans.
The extra time given to policyholders to pay their health insurance premiums after the due date. During the grace period, coverage continues, but failure to pay by the end of the grace period may result in termination of coverage. This applies to ACA, Medicare, and Medicaid plans.
High-Deductible Health Plan (HDHP)
A health insurance plan with a higher deductible and lower premiums. HDHPs are often paired with a Health Savings Account (HSA) to help cover out-of-pocket expenses. These plans are available through the ACA Marketplace and employer-sponsored coverage.
A health insurance plan with a higher deductible and lower premiums. HDHPs are often paired with a Health Savings Account (HSA) to help cover out-of-pocket expenses. These plans are available through the ACA Marketplace and employer-sponsored coverage.
Insurance Premium
The amount paid, often monthly, for health insurance coverage. Premiums are required to maintain enrollment in programs like ACA Marketplace plans, Medicare, Medicaid, and private health insurance.
The amount paid, often monthly, for health insurance coverage. Premiums are required to maintain enrollment in programs like ACA Marketplace plans, Medicare, Medicaid, and private health insurance.
Medicare Part B
The medical insurance component of Medicare that covers outpatient services, doctor visits, preventive services, and some home health care. Part B requires a monthly premium, which is based on income, and there are cost-sharing requirements for services.
The medical insurance component of Medicare that covers outpatient services, doctor visits, preventive services, and some home health care. Part B requires a monthly premium, which is based on income, and there are cost-sharing requirements for services.
Part B (Medicare)
The medical insurance part of Medicare, which covers outpatient services, doctor visits, preventive care, and certain home health services. Part B requires a monthly premium, which is income-based.
The medical insurance part of Medicare, which covers outpatient services, doctor visits, preventive care, and certain home health services. Part B requires a monthly premium, which is income-based.
Premium
The monthly amount paid for health insurance coverage. Premiums are required for plans offered under the ACA Marketplace, Medicare, Medicaid (in some states), and CHIP.
The monthly amount paid for health insurance coverage. Premiums are required for plans offered under the ACA Marketplace, Medicare, Medicaid (in some states), and CHIP.
Qualified Medicare Beneficiary (QMB) Program
A Medicaid program that helps low-income Medicare beneficiaries pay for Medicare Part A and Part B premiums, deductibles, copayments, and coinsurance. Beneficiaries must meet specific income and resource limits to qualify.
A Medicaid program that helps low-income Medicare beneficiaries pay for Medicare Part A and Part B premiums, deductibles, copayments, and coinsurance. Beneficiaries must meet specific income and resource limits to qualify.