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 (Affordable Care Act)
A comprehensive healthcare reform law enacted in 2010, aimed at increasing health insurance coverage, reducing healthcare costs, and improving healthcare outcomes. It established the Health Insurance Marketplace and expanded Medicaid in many states.
A comprehensive healthcare reform law enacted in 2010, aimed at increasing health insurance coverage, reducing healthcare costs, and improving healthcare outcomes. It established the Health Insurance Marketplace and expanded Medicaid in many states.
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.
Bronze Plan
The lowest level of coverage available on the ACA Marketplace, providing the most basic coverage with the lowest premiums but the highest out-of-pocket costs, such as deductibles and copays.
The lowest level of coverage available on the ACA Marketplace, providing the most basic coverage with the lowest premiums but the highest out-of-pocket costs, such as deductibles and copays.
Cost-sharing Reduction (CSR)
A subsidy available through the ACA Marketplace that lowers out-of-pocket costs like deductibles, copays, and coinsurance for eligible individuals. CSR is available to people who enroll in Silver-tier plans and meet specific income requirements.
A subsidy available through the ACA Marketplace that lowers out-of-pocket costs like deductibles, copays, and coinsurance for eligible individuals. CSR is available to people who enroll in Silver-tier plans and meet specific income requirements.
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.
Exchange Plan
A health insurance plan purchased through the ACA Marketplace (also known as the exchange). These plans must meet ACA standards and cover Essential Health Benefits. Exchange plans come in different levels, including Bronze, Silver, Gold, and Platinum.
A health insurance plan purchased through the ACA Marketplace (also known as the exchange). These plans must meet ACA standards and cover Essential Health Benefits. Exchange plans come in different levels, including Bronze, Silver, Gold, and Platinum.
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.
Financial Assistance (ACA)
Subsidies provided through the ACA Marketplace to help eligible individuals and families pay for health insurance premiums and out-of-pocket costs. There are two main types of financial assistance: premium tax credits and cost-sharing reductions.
Subsidies provided through the ACA Marketplace to help eligible individuals and families pay for health insurance premiums and out-of-pocket costs. There are two main types of financial assistance: premium tax credits and cost-sharing reductions.
Gold Plan (ACA)
A health insurance plan offered through the ACA Marketplace that covers approximately 80% of healthcare costs, with the remaining 20% paid by the enrollee. Gold plans have higher premiums but lower out-of-pocket costs compared to Bronze and Silver plans.
A health insurance plan offered through the ACA Marketplace that covers approximately 80% of healthcare costs, with the remaining 20% paid by the enrollee. Gold plans have higher premiums but lower out-of-pocket costs compared to Bronze and Silver plans.
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.
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.
Premium Tax Credit
A subsidy provided under the ACA to help eligible individuals and families pay for health insurance premiums. Premium tax credits are based on income and are available to those purchasing coverage through the ACA Marketplace.
A subsidy provided under the ACA to help eligible individuals and families pay for health insurance premiums. Premium tax credits are based on income and are available to those purchasing coverage through the ACA Marketplace.
Qualified Health Plan (QHP)
A health insurance plan that meets the standards set by the ACA and is certified by the Health Insurance Marketplace. QHPs provide Essential Health Benefits and follow established limits on cost-sharing.
A health insurance plan that meets the standards set by the ACA and is certified by the Health Insurance Marketplace. QHPs provide Essential Health Benefits and follow established limits on cost-sharing.
Subsidy
Financial assistance provided by the government to help individuals and families afford health insurance. ACA Marketplace subsidies include premium tax credits and cost-sharing reductions, which lower the cost of premiums and out-of-pocket expenses.
Financial assistance provided by the government to help individuals and families afford health insurance. ACA Marketplace subsidies include premium tax credits and cost-sharing reductions, which lower the cost of premiums and out-of-pocket expenses.
Silver Plan (ACA)
A mid-level health plan available through the ACA Marketplace that covers approximately 70% of healthcare costs, with the enrollee paying the remaining 30%. Cost-sharing reductions are only available for those who select a Silver plan and meet income requirements.
A mid-level health plan available through the ACA Marketplace that covers approximately 70% of healthcare costs, with the enrollee paying the remaining 30%. Cost-sharing reductions are only available for those who select a Silver plan and meet income requirements.