Category: Glossary

Aka universal health coverage, a government-run insurance system combined with private insurance policies.

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

A government program for folks with lower incomes to help them pay for medical care.  In CA, this program is called Medi-Cal.

An HSA-compatible plan with a high deductible.

If your employer offers this, an account in which to put tax-free money to pay for medical expenses, but you can only contribute a certain amount determined by the feds every year.

The feds decide the income brackets for Medi-caid, cost-share reduction plans with a subsidy, subsidized plans, or not qualifying for assistance.  The FPL guidelines are based on tax filing household and income.  It changes every year.

A law that says that emergency rooms cannot refuse any patient, regardless of their ability to pay.

Don’t exist!   A politician warned that Obamacare would have death panels deciding if sick or elderly people would be allowed to get insurance or letting them die. This wasn’t ever a provision of the ACA.

Think about the term… what does “co” anything mean (think “co-worker” for example)?  Sharing!  You’re sharing costs with the insurance company.

When you go to see an in-network doctor, they submit your medical bills (a claim for benefits) to the insurance company.   Or if you see an out-of-network doctor you submit the claim yourself (if you’re on a PPO).  Once received, the insurance company pays its portion and you might get an invoice from the doctor… Continue reading Claim