Glossary — Learn Insurance Terms and Phrases

Here are some terms that get thrown around whenever people are talking about insurance. There are some very basic ones — and some pretty advanced ones. Look around — hopefully it will give you a better sense of what the insurance companies are talking about.

  1. ALL
  2. A
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  7. F
  8. G
  9. H
  10. I
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  13. L
  14. M
  15. N
  16. O
  17. P
  18. Q
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  22. U
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  24. W
  25. X
  26. Y
  27. Z

Patient Protection and Affordable Care Act (PPACA)

The name of the health care reform law President Barack Obama signed on March 23, 2010.

Platinum / Minimum Coverage / Bronze / Silver / Gold aka Metallic Tiers

Post Obamacare, all health insurance companies have to offer the same metallic tiers.  You can purchase these plans directly from the insurance company OR from your state exchange – but always contact an experienced broker to help you figure it out!  All companies have to offer these policies without a lot of differences (which might vary slightly from state to state).  So when shopping for new plans,  it’s only about the company and their reputation, doctor network and drug formulary.

POS Plans (Point of Service)

No, not THAT POS abbreviation 🙂   Point-Of-Service network model which combines the HMO and PPO models in one plan.

PPACA (Patient Protection and Affordable Care Act)

The name of the health care reform law President Barack Obama signed on March 23, 2010.

PPO – Preferred Provider Organization

With a PPO, you can see any doctor you like, or visit any hospital usually within a preferred network of providers.  You always have the option of seeing doctors or visiting hospitals that are “out-of-network,” but you will spend more of your own money on medical expenses.   In a PPO, you do not have to choose a Primary Care Physician, and you can usually see any specialist without a referral (although a recommendation is always nice!).   The PPO offers choice, flexibility, and more control over your medical life.

Pre-existing Condition

An injury, illness, or physical condition which existed prior to the issue of a health, disability, life, or Long Term Care policy

Premium

What you pay to own the policy

Professional Services

All medical services you receive, from a doctor, lab, hospital, etc.

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