Insurance Terms 1
A set dollar amount you have to meet before health insurance will start helping to pay.
What is a premium.
Insurance provided by the federal and state government for people with low incomes.
What is Medicaid?
What does CMS stand for?
What is Centers for Medicare and Medicaid Services?
A request for your health insurance to review a claim/denial.
What is appeal?
A fixed dollar amount you may have to pay for a service at the time of the service.
What is co-payment?
Give some examples of Durable Medical Equipment (DME).
What is a walker, cane, wheel chair, oxygen tank and tubing, shower chair, etc.
What does ACA stand for?
What is the Affordable Care act?
A provider that has a contract with your health insurance to provide services at a discount.
What is preferred provider?
Depending on your insurance, this may need to be completed in order to receive a medical service or durable medical equipment (DME). This is done to make sure all services/care is medically necessary.
What is pre-authorization/prior-authorization?
Health insurance available to all people 65 years and older and those with certain disabilities.
What does CHIP stand for?
What is Children's Health Insurance Program?
Costs you share with your insurance provider AFTER your deductible is met. Typically you are responsible for 20% of the cost.
What is co-insurance?
Healthcare services that help to improve a patient's function due to an illness or accident.
Ex: A patient learning to talk again after suffering a stroke.
What is rehabilitation services?
What are healthcare services that help a person keep, learn or improve skills of daily living?
What is habilitative services?
What does AMA stand for?
What is American Medical Association?
The most amount you would ever have to pay during a year/policy period for medical services.
What is out-of-pocket limit/max?
A provider that does not have a contract with your insurance to provide services. You will need to pay more money to see this type of provider.
What is a non-preferred provider?
Which insurance is considered public insurance?
What is Medicare, Medicaid, VA, Indian Health Services.
What does HIPAA stand for?
What is Health Insurance Portability and Accountability Act?