Jargon Crossword

Member's share of the costs of a covered service, calculated as a percent of the allowed amount for the service.
Health Reimbursement Account - funded by the ER
Durable Medical Equipment
Primary Care Physician
Cost of having health insurance or plan
Out-of-pocket costs - maximum member pays for a plan year
Long Term Care
Health Savings Account - tax deferred dollars used for qualified medical expenses. Employees,
High Deductible Health Plan - $2700 individual deductible
Minimum Essential Coverage
Affordable Care Act
Long Term Disability
Health Maintenance Organization - requires a PCP as the gateway to care
Employee
Fixed dollar amounts a member pays for covered heath care, usually when receiving a service
Qualifying Life Event
Flexiblie Spending Account - pre-tax monies, Medical, Dependent Care, Limited Medical, Commuter
Summary of Benefits and Coverage
Explanation of Benefits
Usual, Customary and Reasonable - amount paid for medical services in an area based on what area providers usually charge for the same or similar medical services.
Employer
Accidental Death & Dismemberment
Protected Health Information - HIPAA protects members information
Exclusive Provider Organization plan
Preferred Provider Organization - does not require a primary care provider to see a specialist
Special Enrollment Period
Family Medical Leave Act - state and federal
Out-of-network - member will pay more or 100% for out-of-network providers/services unless a true emergency
Short Term Disabiliyt