Monday, November 17
Market Power
The size of one firm relative to its competitors in a given market. Certain insurers or health systems have greater market power which enhances their ability to set prices.
Friday, November 14
Silver Plan
The second lowest actuarial level health plans available through the insurance exchanges, equal to a 70 percent actuarial value. An individual’s subsidy is based on the second lowest cost silver plan in their region. Bronze, Gold, and Platinum plans offer varying actuarial values.
Thursday, November 13
Grandfathered Plan
A health insurance plan already in effect before the provisions of the ACA were implemented that is allowed to continue being offered to enrollees under specific circumstances.
Wednesday, November 12
Maximum Monthly Coverage
Maximum dollar amount that a disabled individual can receive in a given month.
Monday, November 10
Kaiser Subsidy Calculator
An online tool developed by the Kaiser Family Foundation which calculates one’s ACA exchange insurance subsidy based on one’s income.
Friday, November 7
Premium Cap
A limit on the maximum amount an insurer can charge for their coverage.
Thursday, November 6
Percent of Poverty
A term for the income of an individual as it relates to the federal poverty line; it is often used to determine if an individual qualifies for a government program.
Wednesday, November 5
Referral
Process through which a health care provider can recommend a patient visits another doctor - generally when a condition requires the attention of a specialist.
Tuesday, November 4
Elective
Medical treatments or procedures that are not in response to a medical condition or may not be essential to a patient’s health. Common examples would be LASIK eye surgery or wisdom teeth removal.
Monday, November 3
Network
A collection of heath care providers affiliated with an insurer. Care received from these providers is called in-network care, and care received from a non-network provider is called out-of-network care.