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What is the definition of Hardship Exemption?
An exemption allowing allowing applicants 30 and older to qualify for catastrophic coverage.
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What is the definition of coinsurance?
percentage paid after meeting the deductible.
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What is definition of off exchange?
coverage you buy from the direct company, for example buying health insurance directly from BCBS rather than the marketplace.
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What is the definition of generic drugs?
medication w/ the same active ingredients as the brand name, usually costs less.
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What is the definition of in-network coinsurance?
it is the percentage of the allowable amount that you pay for a covered service. In-network coinsurance usually cost less than out-of-network coinsurance.
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What is definition of MOOP Maximum Out of Pocket?
The highest amount a policy holder would pay in a calendar year before the policy will pay 100% of the cost of covered in-network services.
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What is the definition of preferred- generic drugs?
lowest tier in a drug plan/ cost effective to a brand drug.
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What is definition of essential health benefits?
are the 10 categories that health insurance plans must cover under the ACA. Some of the categories include prescriptions, preventative care, and hospitalization.
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What is definition of grievance?
a complaint or dissatisfaction with any aspect of operation or behavior of Medicare health plan.
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What is the definition of inpatient care?
health care that is received when you are admitted to a healthcare facility like a hospital or snf
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What is the definition of brand name drugs?
A prescription drug sold under a specific company that has a patent protecting the specific drug.
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What is the definition of cost sharing reduction?
extra saving , fpl 138% to 250%
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What is definition of on exchange?
buying health coverage through a health insurance exchange, such as the marketplace.
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What is the definition of home health care?
Skilled care directly in patients home, covered under Part A of Medicare.
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What is the definition of health savings account?
this is a type of savings account that allows you to set money aside on a pre-tax basis to help you cover medial expenses.
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What is the definition of Advanced premium tax credit?
A tax credit used to lower the monthly premium and taken in advance of the tax season.
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What is the definition of dependents?
someone is claiming a spouse or a child
anyone financial dependent. |
What is the definition of exemption?
a qualifying life event or hardship that subjects you from paying a tax penalty for not having health coverage
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What is definition of hospital outpatient care?
Covered under part B of Medicare, care received when a patient has not been admitted to a hospital as an impatient.
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What is the definition of medically necessary?
healthcare service and/or supplies needed to diagnose and/or treat an illness, injury, condition, or disease.
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What is definition of Pre-existing Conditions?
A medical diagnosis given prior to a policy effective date. Not a factor with ACA plans.
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What is the definition of domestic partnership?
same benefits as a married couple.
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What is the definition of drug lists?
is the list of drugs covered by a health insurance plan.
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What is the definition of health insurance marketplace?
People who do not have health insurance and helps people shop for and enroll in affordable health insurance.
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What is the definition of network?
a group of facilities, providers, and suppliers that your health insurance has a contract with.
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