GLOSSARY
C
- Capitated Basis
- Carrier
- Carry-over Provision
- Case Management
- Catastrophic Health Plan
- Centers for Medicare & Medicaid Services (CMS)
- Children's Health Insurance Program (CHIP)
- Chronic Care
- Claim
- COBRA
- Coinsurance
- Competitve Bidding
- Complication of Pregnancy
- Conversion
- Coordination of Benefits
- Copayment
- Court Awards
- Creditable Coverage
E
- Eligible Immigration Status
- Employee Contribution
- Employer Contribution
- Employment Retiree Income Security Act of 1974 (ERISA)
- Essential Benefits
- Evidence of Coverage (EOC)
- Evidence of Insurability
- Exclusions
- Exclusive Provider Organization (EPO)
- Expedited Review
- Explanation of Benefits (EOB)
- Extended Coverage
- Extension of Benefits
- External Review
H
- Habilitative/Habilitation Services
- Hardship Exemption
- Health Assessment
- Health Care Workforce Incentive
- Health Insurance Marketplace
- Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- Health Maintenance Organization (HMO)
- Health Plan Categories
- Health Reimbursement Account (HRA)
- Health Savings Account (HSA)
- Health Service Agreement
- High-Cost Excise Tax
- High Deductible Health Plan (HDHP)
- Home and Community-Based Services (HCBS)
- Home Health Care
- Hospice Care
- Hospital Benefits
- Hospital Readmissions
- Hospitalization Insurance
M
- Major Medical Insurance
- Managed Care
- Maternity Coverage
- Max Duration
- Maximum Out-Of-Pocket Costs
- Medicaid
- Medical Group
- Medical Loss Ratio (MLR)
- Medical Necessity
- Medical Savings Account (MSA)
- Medical Underwriting
- Medicare
- Medicare Advantage (Medicare Part C)
- Medicare Beneficiary
- Minimum Essential Coverage
- Medicare Hospital Insurance Tax
- Medicare Part D
- Medicare Supplement Insurance
- Member
- Minimum Value
- Modified Adjusted Gross Income (MAGI)
- Multi-Employer Plan
P
- Patient-Centered Outcomes Research
- Payment Bundling
- Pension (Retirement Benefit)
- Plan Year
- Point of Service (POS) Plans
- Pre-Existing Condition
- Pre-Existing Condition Insurance Plan (PCIP)
- Preferred Provider
- Preferred Provider Organization (PPO)
- Preventive Services
- Premium
- Premium Tax Credit
- Prescription Drug Coverage
- Primary Care
- Primary Care Physician
- Primary Care Provider
S
- Schedule C
- Schedule K-1
- Self-Insured Plan
- Service Area
- Short-term Plans
- Social Security Benefits
- Social Security Survivor Benefits
- Special Enrollment Period
- Special Health Care Need
- State Continuation Coverage
- State Health Insurance Assistance Program (SHIP)
- State Insurance Deparment
- State Medical Assistance Office
- Subrogation
- Subsciber
- Subsidized Coverage
- Summary of Benefits and Coverage (SBC)
- Supplemental Security Income (SSI)
- Standard Industrial Classification (SIC) Codes
- Step Therapy
Complication of Pregnancy
Conditions due to pregnancy, laboe and delivery that require medical care to prevent serious harm to the health of the mother or the fetus.
