A few More Words from the ACA Glossary

dictionary red coverHave you been paying attention to the Affordable Care Act? If not, then there may be a lot of words and phrases that people use to talk about the ACA that you could be unfamiliar with. Fortunately, there is an Affordable Care Act Glossary. Here are a few more words from the ACA Glossary that you should know.

Community Rating: A rule that prevents health insurers from varying premiums within a geographic area based on age, gender, health status, or other factors.

Family and Medical Leave Act (FMLA): A Federal law that guarantees up to 12 weeks of job protected leave for certain employees when they need to take time off due to serious illness or disability, to have or adopt a child, or to care for another family member. When on leave under FMLA, you can continue coverage under your job-based plan.

Formulary: A list of drugs your insurance plan covers. A formulary may include how much you pay for each drug. (If the plan uses “tiers”, the formulary may list which drugs are in which tiers.) Formularies may include both generic drugs and brand-name drugs.

Guaranteed Renewal: A requirement that your health insurance issuer must offer to renew your policy as long as you continue to pay premiums. Except in some states, guaranteed renewal doesn’t limit how much you can be charged if you renew your coverage.

Health Insurance: A contract that requires your health insurer to pay some or all of your health care costs in exchange for a premium.

Insurance Co-Op: A non-profit entity in which the same people who own the company are insured by the company. Cooperatives can be formed at a national, state, or local level, and can include doctors, hospitals and businesses as member-owners.

Patient-Centered Outcomes Research: Research that compares different medical treatments and interventions to provide evidence on which strategies are most effective in different populations and situations. The goal is to empower you and your doctor with additional information to make sound health care decisions.

Rate Review: A process that allows state insurance departments to review rate increases before insurance companies can apply them to you.

Uncompensated Care: Health care or services provided by hospitals or health care providers that don’t get reimbursed. Often uncompensated care arises when people don’t have insurance and cannot afford to pay the cost of care.

Image by Horia Varian on Flickr

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