Category Archives: Health Insurance Glossary
ACOs or Accountable Care Organizations
ACOs (Accountable Care Organizations) are a part of the Health Care Reform Act (HCR) or its official name: Patient Protection and Affordable Care Act (PPACA). This is scheduled to go into effect on January 1 2012 and, for the most part will impact Medicare . ACOs from what I can see look like HMOs but will [...]
Brand-name Drugs Defined
A brand-name drug – prescription drug which is marketed with a specific brand name by the company that manufactures it. So brand-name drugs may cost insured individuals a higher co-pay than generic drugs on some health plans. The recent big news on brand-named drugs vs. generic’s is the story on Lipitor. Lipitor, which became available [...]
Embedded Versus Aggregate Insurance Deductibles
The term embedded deductible means separate individual deductible. In most PPO health plans you have, say a $1,000.00 deductible plan and it has a $3000.00 family deductible. If a policy insures, say three people ( a father, mother and daughter) and two of them have medical procedures in the same year, then each must first [...]
Health Insurance Aggregate Deductible
An important distinction needs to be made concerning how deductibles are computed for Qualified High-Deductible Health Plans. The family deductible is an aggregate or combined deductible. Each person’s covered medical expenses go toward meeting the family deductible. Each insured person’s covered medical expenses go toward meeting this amount. Once the family deductible is met, most [...]
Health Insurance Deductibles
The deductible in a health Insurance policy is a defined dollar amount during the benefit period – usually a year – that the insured person pays before the insurance company starts to make payments for covered medical services. Plans may have both per individual and family deductibles. Some plans may have separate deductibles for specific [...]
Insurance Actuary Defined
An actuary is a mathematician in the insurance field. They are responsible for calculating premiums, developing plans and defining underwriting risk. A person who is an actuary by training or collage degree can work as an insurance company “underwriter”. This is the person that evaluates the risk in taking on a new policy for the [...]
BMI & Personal Weight
What is BMI (Body Mass Index)? How is it calculated and what use is it to me and Insurance companies? BMI is a number based on a person’s weight and height that provides a way to estimate the effect of weight on health. The higher the BMI, the greater the risk of diseases such as [...]
Agent – Broker | Glossary of Insurance Terms
I am picking up on my Glossary of term topic and am going to the beginning of the alphabet for this. I will talk of the title of Insurance Agent and Broker. An agent – a licensed individual who represents several insurance companies and sells their products. There are also agents that sell for and [...]
Credit for Prior Credible Coverage
Any pre-existing condition waiting period met under an employer’s prior (qualifying) coverage will be credited to the current plan, if any interruption of coverage between the new and prior plans meets state guidelines. Not having a lapse in Health Insurance can be very important, especially if you have health issues. If you go without Health [...]
Health Insurance Terms | Co-insurance & Stop-loss
This posting is a continuation of the series on Health Insurance Terms. In a Health Insurance policy, once you have met your deductible, if you do not have a 100 percent plan then you are in the part of the policy of Co-insurance. That is where the insured and the insurance co share in the [...]
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