Tyler. LaFoxie. Lolita. Amya. Tashikya.
100
What is the definition of Hardship Exemption?
An exemption allowing allowing applicants 30 and older to qualify for catastrophic coverage.
100
What is the definition of coinsurance?
percentage paid after meeting the deductible.
100
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.
100
What is the definition of generic drugs?
medication w/ the same active ingredients as the brand name, usually costs less.
100
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.
200
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.
200
What is the definition of preferred- generic drugs?
lowest tier in a drug plan/ cost effective to a brand drug.
200
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.
0
What is definition of grievance?
a complaint or dissatisfaction with any aspect of operation or behavior of Medicare health plan.
200
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
300
What is the definition of brand name drugs?
A prescription drug sold under a specific company that has a patent protecting the specific drug.
300
What is the definition of cost sharing reduction?
extra saving , fpl 138% to 250%
300
What is definition of on exchange?
buying health coverage through a health insurance exchange, such as the marketplace.
300
What is the definition of home health care?
Skilled care directly in patients home, covered under Part A of Medicare.
300
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.
400
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.
400
What is the definition of dependents?
someone is claiming a spouse or a child
anyone financial dependent.
400
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
400
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.
400
What is the definition of medically necessary?
healthcare service and/or supplies needed to diagnose and/or treat an illness, injury, condition, or disease.
500
What is definition of Pre-existing Conditions?
A medical diagnosis given prior to a policy effective date. Not a factor with ACA plans.
500
What is the definition of domestic partnership?
same benefits as a married couple.
500
What is the definition of drug lists?
is the list of drugs covered by a health insurance plan.
500
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.
500
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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