TOPIC 1
I’m homeless what do I qualify for?
HARDSHIP EXEMPTION
What is the least expense/ paying difference after the insurance pays that is member responsibility?
IN-NETWORK COINSURANCE
What discount you will receive if you fall between 150%-300% FPL?
COST SHARING REDUCTION
What do you call an alternative to a original drug?
GENERIC DRUG
What are available plans on marketplace, under the ACA?
ON EXCHANGE
Contracted healthcare providers in a geographic area?
NETWORK
What is an illness that being treated prior to coverage?
PRE-EXISTING CONDITION
Clinical Lab Services, durable medical equipment, and other outpatient services fall under what type of care?
HOSPITIAL OUTPATIENT CARE
What are individuals living within the same household unmarried?
DOMESTIC PARTNERSHIP
If you have affordability or financial issues what am I called?
The most you will pay out in a calendar year for healthcare is?
MOOP MAXIMUM OUT OF POCKET
Admitted to hospital for care?
INPATIENT HOSPITAL
What is one of the least expensive original drug type?
PREFERRED GENERIC DRUGS
What do you call a complaint?
GRIEVANCE
What is the benefit for Maternity and Newborn care?
ESSENTIAL HEALTH BENEFITS
When a medication or service is deemed needed by a provider is called?
MEDICALLY NECESSARY
What tax credit is based on your estimated income?
ADVANCED PREMIUM TAX CREDIT(APTC)
What is the exchange for PPACA and health plan shopping?
HEALTH INSURANCE MARKETPLACE
What are individuals spouse/children that are supported by the primary insured?
DEPENDENTS
What is the name of an insurance company formulary for IFP?
DRUG LIST
What is a non generic original formula drug?
BRAND NAME DRUG
What is the term for a high deductible health plan which combines a savings account?
HEALTH SAVINGS ACCOUNT
What the insured pays after the insurance has paid for approved services?
COINSURANCE
What is an option for a member to receive health care services at their residence?
HOME HEALTH CARE
What is the plans not within Marketplace?
OFF EXCHANGE