Monday, July 7
Gag Clause
A provision in a contract in which a health care provider is restricted in speaking about an insurer or their financial arrangement.
Thursday, July 3
Section 125 Plan
A plan that allows for employees to pay for health insurance premiums and receive certain benefits on a pre-tax basis.
Wednesday, July 2
Fiscal Year (FY)
A period used for calculating annual financial statements in business and other organizations.
Tuesday, July 1
Medicare Part A
Section of Medicare that includes medically necessary hospital, skilled nursing facility, home health and hospice care.
Monday, June 30
Gatekeeper
A colloquial term for a primary care physician who is responsible for coordinating patient care and referring the patient to specialists. Many insurance programs, particularly HMOs, require a referral from a "gatekeeper" before covering visits to specialists.
Friday, June 27
Guest Privileges
A component of some insurance plans allowing enrollees to visit out of network doctors if they are temporarily away from home.
Thursday, June 26
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.
Wednesday, June 25
High-Risk Pool
State programs aimed at offering health insurance to individuals considered uninsurable and unable to buy coverage on the individual market.
Tuesday, June 24
Co-payment
A required cost paid by the insured person each time a medical service is used.
Monday, June 23
COBRA
Consolidated Omnibus Budget Reconciliation Act of 1985. Through this act employees are able to continue their employer-sponsored coverage for up to 18 months if they lose their job. The original legislation required individuals to pay full premiums to continue their coverage through COBRA. A temporary subsidy of 65% of the premium cost for the purchase of COBRA coverage for individuals who have lost their jobs between September 1, 2008 and December 31, 2009 was provided through The American Recovery and Reinvestment Act (ARRA).