| A | B |
|---|
| health insurance | Provides compensation for losses due to injury, illness, or disability |
| basic medical | Pay a large part of hospital and medical care, may also pay part of some other expenses (e.g. doctor's visits) |
| major medical | Pay for long-term illness expenses after basic medical benefits limits have been reached (e.g. cancer) |
| HMO | Health management organization---a health care group that provides health care services to members for a set fee and small co-pay. |
| HSA | Health savings account---you contribute pre-tax dollars to teh account for expected medical expenses for the coming year-often set up through your employer-submit claims and receipts for reimbursement up to amount deposited. |
| PPO | Preferred providers organization---an agreement between health providers with employers or insurers to provide services at a reduced rate to employees. |
| POS | Point of service---members use a primary physician who refers them as needed to participating specialists or members can see non-participating health providers |
| fee-for-services plan | A plan in which an insured can select his/her own doctors and hospitals, pay costs at time of visit, and file form with insurance company for reimbursement of covered expenses |
| CHIP | Children's Health Insurance Program - health insurance for children under 18 whose parents earn too much to qualify for Medicaid, but not enough to afford private insurance |
| disability | An illness or injury that leaves a person unable to work |
| long term care | Pays for care when a person with a serious illness or injury cannot care for themselves for an extended period of time |
| worker's compensation | Employers are required to have in every state in some form. Covers medical care, treatment, rehabilitation, and a portion of wages from injuries that occur in the workplace. |
| Medigap insurance | May be purchased by Medicare recipients to cover part/all expenses not covered by medicare. |
| COBRA | A federal law that someone who leaves employment may be eligible to keep insurance coverage at his/her own expense up to six months. |
| pre-existing condition | An illness or injury that a person has at the time he/she enrolls in a health care plan |
| renewability | A patient's right to restart coverage annually |
| maximum benefit | A limit on the number of days one's care will be covered, or the highest amount that can be paid in benefits for a specific precedure |
| open enrollment period | A time period during which a person can enroll in a health care plan |
| exclusion | An uncovered medical service |
| preauthorization | A requirement to obtain approval from the plan before having certain treatments or procedure done |
| primary care physician | A doctor who provides general medical care and coordinates other health care |
