NEED HELP IN UNDERSTANDING YOUR HEALTH INSURANCE ?
Unsure of some of the terms used in your policy or reports? You will be happy to know that the Health Issues committee of our LWVPBC has composed a glossary of health insurance terms to assist you.
AHC A – American Health Care Association (a non-profit federation of affiliated state health organizations).
ACA – Affordable Care Act (aka Obamacare)
AAAHC – Accreditation Association for Ambulatory Health Care
Catastrophic Health Plan – one that provides minimal coverage
CHAIN – Community Health Action Information Network (A statewide consumer health advocacy organization)
CHIP – Children’s Health Insurance Program
CTG – Close the Gap (a statewide attempt to expand Medicaid coverage to the working poor)
CMS – Children’s Medical Services (Note – CMS can also stand for the Federal Center for Medicare and Medicaid Service)
COBRA – Consolidated Omnibus Budget Reconciliation Act (a federal law that allows you to temporarily keep health coverage after your employment ends, but you must pay for it).
Coverage Gap – uninsured poor adults in states that do not expand Medicaid
DSH – Disproportionate Share Hospital
FPL – Federal Poverty Level (used to determine eligibility for Medicaid and CHIP) Example-$11,880 for individuals and $16,020 for a family of 2.
FHA – Florida Health Alliance
FHIX – Florida Health Insurance Affordability Exchange Program (State Senate Bill 7044)-did not pass
FQHC – Federally Qualified Health Center (49 in FL, with 426 clinics)
GME – Graduate Medical Education
GP – General Practioner
HCFA – HealthCare Financing Administration (replaced by Federal CMS)
HHS – Health and Human Services (Federal program)
HIPAA – Health Insurance Portability and Accountability Act (protects patients’ privacy)
HMO – Health Maintenance Organization (a medical insurance group that provides healthcare for a fixed annual fee). (Examples – Cigna, Kaiser Permanente, Humana, etc.)
LIP – Low Income Pool (Federal funds for healthcare assistance to hospitals)
MCO’s – Managed Care Organizations
Medicaid – a joint federal and state program that helps with medical costs for some people with limited income.
Medicaid Managed Care Program – a system of providing Medicaid services using MCO’s.
Medicare – National Social Insurance Program, mostly for people aged 65 and over.
Medicare Part A – hospital coverage
Medicare Part B – the bulk of healthcare, received as an outpatient (includes doctor’s visits, laboratory, etc.).
Medicare Part C – aka as Medicare Advantage plans. It is an alternative to standard Medicare. (You can choose Part C, OR regular Medicare, which is Part A & B.)
Medicare Part D – Prescription Drug Coverage
Medigap plans – Supplemental health insurance plans.
Millenials – students and young workers aged 18-32, who can particularly benefit from strengthening Medicaid
PCP – Primary Care Physician
PPO – Preferred Provider Organization (a managed care organization of doctors, hospitals, etc. who have reached an agreement with third party (insurers) to provided healthcare at reduced rates.
Preventive screenings – similar to “wellness checks”
RAM – Remote Area Medical (a volunteer medical relief corps)
Safety Net Hospitals – hospitals and clinics that provide a significant level of care to low-income, uninsured, and vulnerable populations. (Examples: Jackson Memorial, Broward Health, H. Lee Moffitt, etc.)
SCHIP – State Children’s Health Insurance Program
SNIF – Skilled Nursing Facility
SSA – Social Security Act (Medicare was enacted under this)
“State- based solutions” – refers to support of local bills as opposed to Federal mandates
Supplemental Insurance – extra insurance that you can purchase to help you pay for deductibles, co-pays, etc.
Tricare– healthcare program for military personnel (Note – it replaced CHAMPUS.)
Universal Healthcare – aka “socialized medicine”, “single-payor”, etc.
VIP Health Insurance – aka Concierge Medical Practice. The PCP sees a fixed number of patients, who pay an annual fixed fee. They usually do not bill insurance.
WHO – World Health Organization