Glossary
Tags
- ACA
- ACA Marketplace
- ACA subsidies
- CHIP
- CMS
- ESRD
- Extra Help
- FMAP
- FPL
- FQHC
- FSA
- HCBS
- HMO
- HRA
- HSA
- IEP
- IRMAA
- Joint Commision
- KFF
- LCD
- LIS
- Marketplace
- Medicaid
- Medicaid (rare)
- Medicaid expansion
- Medicare
- Medicare Advantage
- Medicare Part A
- Medicare Part B
- Medicare Part D
- Medicare coordination
- Medigap
- NCD
- NEMT
- NOMNC
- Original Medicare
- PCP
- Part A
- Part B
- Part C
- Part D
- QLE
- QMB
- SEP
- SNF
- SNP
- SSI
- Section 1115
- Silver Plan
- Silver plan
ACA Marketplace
An online platform where individuals can shop for, compare, and purchase health insurance plans offered under the ACA. It offers tiered plans (Bronze, Silver, Gold, Platinum) with varying coverage levels and costs.
An online platform where individuals can shop for, compare, and purchase health insurance plans offered under the ACA. It offers tiered plans (Bronze, Silver, Gold, Platinum) with varying coverage levels and costs.
Annual Enrollment Period (AEP)
A yearly period (October 15 to December 7) when Medicare beneficiaries can make changes to their health and prescription drug coverage, including switching between Medicare Advantage plans or enrolling in Medicare Part D.
A yearly period (October 15 to December 7) when Medicare beneficiaries can make changes to their health and prescription drug coverage, including switching between Medicare Advantage plans or enrolling in Medicare Part D.
Automatic Enrollment
The process by which individuals are automatically enrolled in a health insurance plan, often through programs like Medicare when they reach age 65 or when they begin receiving Social Security benefits.
The process by which individuals are automatically enrolled in a health insurance plan, often through programs like Medicare when they reach age 65 or when they begin receiving Social Security benefits.
Exchange (Health Insurance Marketplace)
Also known as the Health Insurance Marketplace, the exchange is an online platform where individuals can compare and purchase ACA-compliant health insurance plans. The Marketplace also provides information on subsidies and tax credits for eligible individuals.
Also known as the Health Insurance Marketplace, the exchange is an online platform where individuals can compare and purchase ACA-compliant health insurance plans. The Marketplace also provides information on subsidies and tax credits for eligible individuals.
Enrollment Period
The designated time frame during which individuals can sign up for or make changes to their health insurance coverage. Medicare has an Annual Enrollment Period, and the ACA Marketplace has an Open Enrollment Period.
The designated time frame during which individuals can sign up for or make changes to their health insurance coverage. Medicare has an Annual Enrollment Period, and the ACA Marketplace has an Open Enrollment Period.
Health Insurance Marketplace
An online platform established by the ACA where individuals and small businesses can compare and purchase health insurance plans. It also provides information on eligibility for subsidies and cost-sharing reductions.
An online platform established by the ACA where individuals and small businesses can compare and purchase health insurance plans. It also provides information on eligibility for subsidies and cost-sharing reductions.
Initial Enrollment Period (IEP)
The seven-month window when an individual is first eligible to sign up for Medicare Part A and Part B. This period begins three months before the individual turns 65, includes their birthday month, and extends three months after.
The seven-month window when an individual is first eligible to sign up for Medicare Part A and Part B. This period begins three months before the individual turns 65, includes their birthday month, and extends three months after.
Open Enrollment Period (OEP)
The yearly period during which individuals can enroll in or make changes to their ACA Marketplace, Medicare Advantage, or Medicare Part D plans. Outside of this period, enrollment is only allowed with a qualifying life event.
The yearly period during which individuals can enroll in or make changes to their ACA Marketplace, Medicare Advantage, or Medicare Part D plans. Outside of this period, enrollment is only allowed with a qualifying life event.
Qualifying Life Event (QLE)
A major life event that allows an individual to enroll in or make changes to their health insurance plan outside of the Open Enrollment Period. Examples of QLEs include marriage, divorce, birth of a child, or loss of other health coverage.
A major life event that allows an individual to enroll in or make changes to their health insurance plan outside of the Open Enrollment Period. Examples of QLEs include marriage, divorce, birth of a child, or loss of other health coverage.
Waiting Period
The period of time between the date a person applies for health insurance and the date coverage begins. Waiting periods are sometimes imposed in employer-sponsored health plans, but under the ACA, they cannot exceed 90 days. Medicaid and CHIP usually do not have waiting periods for coverage.
The period of time between the date a person applies for health insurance and the date coverage begins. Waiting periods are sometimes imposed in employer-sponsored health plans, but under the ACA, they cannot exceed 90 days. Medicaid and CHIP usually do not have waiting periods for coverage.