P

Pre-existing Condition

A medical issue, problem, or illness that an individual is already suffering from before applying for/receiving new insurance.

Pre-Existing Condition Exclusions

This is a provision in a health insurance plan offered to an individual with a past or current health condition whereby treatment related to the individual's “pre-existing condition” is not covered.

Pre-existing Condition Insurance Plan

Provides temporary insurance for individuals with pre-existing conditions who had been previously uninsured.

Preferred Provider Organization (PPO)

A form of health insurance in which the enrollee pays a smaller portion of health care costs when they use pre-approved health care providers.

Premium

Refers to the amount paid for health insurance, usually on a monthly basis.

Premium Cap

A limit on the maximum amount an insurer can charge for their coverage.

Premium Increase Review

Insurance providers are required to explain, to state and federal officials, any 'unreasonable' premium increases.

Premium Subsidies

A fixed percentage of the premium cost that helps individuals purchase health coverage on the new health insurance exchanges.

Premium Support

A proposal to give Medicare-eligible populations a set amount of money and then let them chose a private insurance plan to provide health care benefits.

Premium Tax’

Fee levied on health insurance companies

Formulary

A list of prescription drugs that health plans will pay for in-part or in-full.