Copy of `CNH - Health insurance terms`

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CNH - Health insurance terms Category: Health and Medicine Date & country: 22/07/2014, USA Words: 43

Short-term Insurance
A type of health insurance that covers certain services for a set time period (6 months or less). Learn more about short-term insurance.

Urgent Care Provider
A provider of services for health problems that need medical help right away but are not emergency medical conditions.

Provider (Healthcare Provider)
A hospital, facility, physician or other licensed healthcare professional.

Premium
This is the amount of money you will pay each month for your health insurance plan. In general, the higher the monthly premium you pay, the less you

Preventive Care
This includes medical services like annual checkups, shots and screening tests to help you stay healthy, even if you aren

Premium
Payments you make to your insurance provider to keep your coverage. The payments are due at certain times.

Prescription Drug
Any medicine that may not be given without a prescription because of federal or state law.

Out-of-pocket Cost
Cost you must pay. Out-of-pocket costs vary by plan and each plan has a maximum out of pocket (MOOP) cost. Consult your plan for more information.

Outpatient Services
Services that do not need an overnight stay in a hospital. These services are often provided in a doctor

Out-of-Pocket Costs
These are your expenses for medical care that aren

Out-of-Pocket Maximum
This is the maximum amount you pay during a policy period (usually a calendar year) before your health insurance begins to pay 100% of the allowed amount. If you require a lot of medical services, choosing a plan with a lower out-of-pocket maximum may save you money, even if that plan has a higher monthly premium.

Non-covered Charges
Charges for services and supplies that are not covered under the health plan. Examples of non-covered charges may include things like acupuncture, weight loss surgery or marriage counseling. Consult your plan for more information.

Medical Care
Medical services received from a healthcare provider or facility to treat a condition.

Medicare
A federal program for people age 65 or older that pays for certain healthcare expenses.

Institution (Institutional)
A hospital or certain other facility.

Legal Guardian
The person who takes care of a child and makes healthcare decision for the child. This person is the natural parent or was made caretaker by a court of law.

Long-term Insurance
A type of health insurance that covers certain services over a set amount of time (typically a 12-month period).

Metal Level
Every plan available to New Hampshire residents through the Health Insurance Marketplace is organized by a metal level

Individual Mandate Penalty
Under the new health care law, most individuals who aren

Inpatient Services
Services received when admitted to a hospital and a room and board charge is made.

HSA (Health Savings Account)
An account that lets you save for future medical costs. Money put in the account is not subject to federal income tax when deposited. Funds can build up and be used year to year. They are not required to be spent in a single year. HSAs must be paired with certain high-deductible health insurance plans (HDHP).

HRA (Health Reimbursement Account)
An account that lets an employer set aside funds for healthcare costs. These funds go to reimburse Covered Services paid for by employees who take part. An HRA has tax benefits for employer and employees.

Health Assessment
A health survey that measures your current health, health risks and quality of life.

Dependent Coverage
Coverage for your dependents who qualify.

Emergency Medical Condition
A medical problem with sudden and severe symptoms that must be treated quickly. In an emergency, a person with no medical training and an average knowledge of health/medicine could reasonably expect the problem could:

FSA (Flexible Spending Account)
An FSA is often set up through an employer plan. It lets you set aside pre-tax money for common medical costs and dependent care. FSA funds must be used by the end of the term-year. It will be sent back to the employer if you don't use it. Check with your employer's Human Resources team. The can provide a list of FSA-qualified costs that you can purchase directly or be reimbursed for. A few common FSA-qualified costs include:

Deductible
This is the amount you have to pay out-of-pocket each year before your health insurance plan will pay anything toward the cost of your medical services. For example, if your deductible is $1,000, your plan will not start paying anything until you have spent $1,000 for medical services that are subject to the deductible. Remember, the deductible may not apply to all services.

Deductible
The amount you pay for your healthcare services before you health insurer pays. Deductibles are based on your benefit period (typically a year at a time). Learn about deductibles here.

Covered Charges
Charges for covered services that your health plan paid for. There may be a limit on covered charges if you receive services from providers outside your plan's network of providers.

Covered Person
Any person covered under the plan.

Covered Service
A healthcare provider

Creditable Coverage
Coverage of a person under any of these:

Condition
An injury, ailment, disease, illness or disorder.

Contract
The agreement between an insurance company and the policyholder.

Copayment (Copay)
The amount you pay to a healthcare provider at the time you receive services. You may have to pay a copay for each covered visit to your doctor, depending on your plan. Not all plans have a copay.

Coinsurance Limit (or Maximum)
The most you will pay in coinsurance costs during a benefit period.

Coinsurance
A certain percent you must pay each benefit period after you have paid your deductible. This payment is for covered services only. You may still have to pay a copay.

Copay
This is a fixed amount you pay for a medical service covered by your health insurance plan. For example, you may be required to pay $30 every time you visit your primary care doctor, regardless of the type of care you receive.

Cost Sharing Reduction
This is a discount that lowers the amount you have to pay out-of-pocket for deductibles, coinsurance, and copayments if you purchase a health insurance plan through the Marketplace. . You can check now to see if you qualify for cost sharing reduction on the Financial Assistance page of this website.

Allowed Amount
The highest amount we will cover (pay) for a service.

Benefit Period
When services are covered under your plan. It also defines the time when benefit maximums, deductibles and coinsurance limits build up. It has a start and end date. It is often one calendar year for health insurance plans.

Coinsurance
This is your share of the costs of a covered medical service, calculated as a percentage of the allowed amount for the service. So if you incur a medical bill of $1,000 for a particular medical procedure or treatment and your plan has a 20% coinsurance level for that particular procedure or treatment, you will have to pay $200 out-of-pocket, and your insurance will cover the rest.

Advanced Premium Tax Credit
This is a new tax credit to help you afford health coverage purchased through the Health Insurance Marketplace. If you qualify for financial assistance, advanced payments of the tax credit can be used right away to lower your monthly premium costs. You can check now to see if you qualify for lower premiums on the Financial Assistance page of this website.