| Term | Definition |
|---|
| Benefit Package | The list of services or producdes that a health care plan covers. |
| Capitation | System of payment used by managed care plans in which physicians and hospitals are paid a fixed, per capita amount for each patient enrolled over a stated period regardless of the type and number of services provided; reimbursement to the hospital on a per-member/per-month basis to cover costs for the members of the plan. |
| Cherry-picking | A processed used by private insurers that only tries to cover the healthiest people, lowering the risk of health services. |
| Community Rating | This rule is part of the new bill, it requires insurance companies to set premium rates based on a person's gender, age and geography. |
| Guaranteed Issue | This rule, part of the new bill, will require insureance companies to offer health coverage to anyone willing and not deny coverage over a pre-existing condition. |
| Comparative Effectiveness Research | Reserarch that compares two or more drugs or treatments to see which is more effective for a certain patient, this will be used by all insureance providers. |
| Employer Mandate | The requirement of businesses to offer health insureance to their employees, this is only for businesses of a certain size. |
| Fee-for-service | The traditional way to pay doctors for each service provided. |
| Health Insurance Cooperative | A nonprofit health plan owned and operated by a collection of small businesses or people so they have more negotiating power |
| Health Insurance Exchange | A marketplace were people can buy insureance that is set up at a state, regional or national level, in this the government can regulate plans that are offered. |
| High-risk pool | A state funded insurance pool that's for peole who were denyed medical coverage, only some states have these. |
| Individual Mandate | The requirment, under the pulic plan, that requires all individuals to purchase health insurance voerage. |
| Medicaid | a federal and state assistance program that pays for health care services for people who cannot afford them |
| Medicare | a federal insurance program for persons over the age of 65 and qualified disabled or blind persons regardless of income |
| Medicare Advantage | A Medicare program, formerly known as Medicare+Choice, that provides additional health plan options such as HMOs and PPOs as alternatives to the original Medicare fee-for-service plan. |
| Medical Underwritting | An insurance processof evaluating an individual's health statues to deside the cost of premiums and if they should be offered insurance. |
| Pay for performance | A system that would pay health care previders based on how well they take care of patients. |
| Pre-existing condition | A previous injury, disease, or physical condition that existed before the health insurance policy was issued. |
| Premium | payment for insurance |
| Public Plan | A government run option in the health insureance exchange to compete with private insurers, like medicare. |
| Purchasing Pool | Health care providers teaming up to negotiate a lower price on a certain product. |
| SCHIP | The State Children's Health Insureance Program is a $10 billion program that offers health care to childrens not poor enough to receve mediaid. |
| Single-payer system | A health care system that all funding comes from one source, ussally the government and private insureace still exists. |
| Socialized Medicine | a medical care system in which the government owns and operates most medical facilities and employs most physicians |
| Uncompenstated Care | free care that doctors and hspitals provide to patients. |
| Underinsured | A term descibing people who have insureance but are sitll considered financially vulnerable to hight health expences |
Combine with other sets
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