Healthcare terms are varied and can be confusing at times. The purpose of this glossary is to demystify and clarify. If you have any questions or terms you feel should be included, please contact us [email protected]
| TERM | DEFINITION |
| SB 1129 | Senator Bernie Sanders' Medicare for All Act |
| HR 1384 | Representative Pramila Jayapal's Medicare for All Act |
| Buy-In | To pay money to secure a position or place in some organization, especially a business. |
| Conflict of Interest | A situation in which the concerns or aims of two different parties are incompatible; one party could be in a position to receive personal benefits from actions or decisions made in their official capacity, such as an insurance company or politician. |
| Co-Insurance | A certain percent you pay every benefit period after you have paid your deductible, or your share of the costs of a covered health care service |
| Co-Pay | Amount an individual pays for an office visit; often times this is a flat fee |
| Coronavirus or COVID-19 | Family of RNA viruses that affect both animals and humans, and which can cause illness in humans ranging from the common cold to more severe diseases |
| Deductible | Amount paid by individual before insurance pays |
| Long-term care insurance | Additional insurance plan that covers nursing home care, home health care, personal care or adult day care for individuals age 65+ |
| Medicaid | A medical benefits program administered by each individual state and subsidized by the Federal government; which helps with medical costs for individuals with low incomes, limited assets, and/or disabilities. |
| Medicare | A government program that provides health insurance to cover medical costs for people aged 65 and older. Link to Medicare Glossary#1 Link to Medicare Glossary#2 |
| Medicare Advantage Plans | Offered by private companies, with approval from Medicare, who then pays these companies to cover your Medicare |
| Medicare for All |
National health insurance for everyone living in the United States |
| Medicare Part D |
Program that helps to pay for prescription drugs under Medicare plans |
| Medigap |
Private insurance plans that supplement Original Medicare coverage. |
| National vs state based | Health insurance run by the federal government vs Health insurance run individual states |
| Network | Providers who accept your particular insurance: doctors, clinics, hospitals |
| Original Medicare (Traditional Medicare) | Medicare Parts A & B |
| OPX | Out of pocket maximum: how much an individual can pay in a year, beyond his/her premium. |
| Pandemic | An outbreak of a disease that occurs over a wide geographic area and affects an exceptionally high proportion of the population |
| PHARMA/PHRMA | The pharmaceutical industry |
| Privatizing Medicare | Changing Medicare from a guaranteed benefits program as it stands today, into one where individuals would have to buy their own health insurance |
| Public Option | A government-run health insurance agency from which people could purchase policies instead buying from private health insurers |
| Risk Pool | A health insurance risk pool is a group of individuals whose medical costs are combined to calculate premiums |
| Risk Score | A combination of health factors which predict the likelihood that an individual will experience a particular outcome such as going to the hospital or getting a particular disease |
| Single insurer health care system | Same as single-payer; a government run system in which everyone gets health care from one insurer |
| Single payer | A government system, typically backed by taxes, in which everyone gets health care from one insurer, run by the government |
| Social Insurance | Public national health insurance. Money that is paid to the government by employers and employees so people can acquire money if they are unable to work because of their age, illness, if they're unemployed, etc. |
| Socialized medicine | A system in which the government owns all the facilities and the providers are government employees. Examples are the National Health Service of Great Britain,The Veterans Administration, the US Military and Denver Health |
| Takings | An action by the federal government, as a regulatory ruling, that imposes a restriction on the use of private property for which the owner must be compensated. |
| TRICARE | Healthcare program for active and retired military and their families |
| Universal healthcare | A system that provides quality medical services and financial protection to all residents |
