Your Source for Health Reform

ACA Word
of the Week

 

In 2014, we started a “Word of the Week” social media campaign to help people become more familiar with health care vocabulary. We define the term on Monday – like this – and post facts and resources about it all week long. Enjoy the archive below, and follow us on Twitter to get the latest, freshest #ACAwow.

Learn about   Appeal  - Assister  - Behavioral Health Provider  -  Benefits  -  Broker  -  Coinsurance  -  Consumer ProtectionsCopaymentsCost Sharing Reduction  -  Deductible  -  Dental Coverage  -  Dependent  -  Dietitian  -  Donut Hole  -  Durable Medical Equipment  -  Enrollment  -  Fee for Service  -  Formulary  -  Generic Drugs  -  Group Health Plan  -  Guaranteed Issue  -  Health Insurance  -  Health Insurance Marketplace  -  Immunization  -  Insurance Carrier  -  Long Term Care  -  Medicaid  -  Medical Loss Ratio  -  Medicare  -  Medicare Part D  -  Multidisciplinary Team  -  Navigator  -  Network  -  Open Enrollment  -  Physical & Occupational Therapists  -  Preauthorization  -  Pre-Existing Condition  -  Premium  -  Premium Tax Credit  -  Preventive Services  -  Primary care provider  -  Qualifying Life Event  -  Referral  -  Social Worker  -  Special Enrollment Period  -  Summary of Benefits and Coverage  -  Tax Household  -  Well-Woman Visit  -  Wellness Programs


HEALTH INSURANCE

 

PRE-EXISTING CONDITION

 

 

TAX HOUSEHOLD

 

DECUCTIBLE

  • Our Twitter #ACA word of the week for February 24 – March 2, 2014
  • #ACA word of the week: DEDUCTIBLE – money you have to pay before health insurance benefits can be enjoyed http://bit.ly/1hsNtAx
  • You can still get services before you have met your DEDUCTIBLE…for free! http://1.usa.gov/1nL9M1Y
  • Feeling befuddled about DEDUCTIBLES? It’s our word of the week http://1.usa.gov/1fWNbkN
  • So my preventive services are free and accessible before I’ve paid my DEDUCTIBLE? http://1.usa.gov/1nL9M1Y

 

DEPENDENT

 

PREMIUM

 

COINSURANCE

 

HEALTH INSURANCE MARKETPLACE

  • Our Twitter #ACA word of the week for March 24-30, 2014
  • The HEALTH INSURANCE MARKETPLACE: where you’ll go this week if you aren’t covered http://bit.ly/19U8Nqh
  • What is the HEALTH INSURANCE MARKETPLACE? You should visit before March 31st http://1.usa.gov/MpkYFi
  • Go on. Do it for your puppy. #GetCovered at the HEALTH INSURANCE MARKETPLACE http://bit.ly/1jhFu6W

 

SPECIAL ENROLLMENT PERIOD

  • Our Twitter #ACA word of the week for March 31 – April 6, 2014, and March 2-8, 2015
  • #ACA word of the week: SPECIAL ENROLLMENT PERIOD – when you can #GetCovered after Open Enrollment ends http://1.usa.gov/1gCDBn0
  • Learn about SPECIAL ENROLLMENT PERIODS for complex cases on the marketplace http://1.usa.gov/1hg4rM4
  • Got a new job? Awesome, you get a SPECIAL ENROLLMENT PERIOD too!
  • There may be gifts on your registry, but the bride & groom also qualify for a SPECIAL ENROLLMENT PERIOD
  • Use the SPECIAL ENROLLMENT PERIOD screener to see if you can get covered now http://1.usa.gov/1iRSy6M
  • Bookmark our roundup of SPECIAL ENROLLMENT PERIOD resources & links http://bit.ly/13I5INj

 

QUALIFYING LIFE EVENT

  • Our Twitter #ACA word of the week for April 7-13, 2014
  • #ACA word of the week: QUALIFYING LIFE EVENT – this allows you to have a special enrollment period http://1.usa.gov/1hWth5C
  • QUALIFYING EVENTS. This is what they are http://bit.ly/1gCB1xk
  • An IHM original, learn about QUALIFYING EVENTS and special enrollment periods http://bit.ly/1iDtECu
  • Moving to a new state and changes in your income or your family size if you marry, divorce, or have a baby are examples of QUALIFYING LIFE EVENTS

 

PREVENTIVE SERVICES

 

PRIMARY CARE PROVIDER

 

NETWORK

 

WELLNESS PROGRAMS

 

WELL-WOMAN VISIT

 

COPAYMENTS

 

REFERRAL

  • Our Twitter #ACA word of the week for May 26 – June 1, 2014
  • #ACA word of the week: REFERRAL – a primary doc’s order to see a specialist http://1.usa.gov/1nk5uEi
  • REFERRALS help your doctor keep track of the care you’re receiving http://bit.ly/1nc5Vhb
  • Always check with your primary care doctor for a REFERRAL before seeing a specialist http://bit.ly/1nc5Vhb
  • You don’t always need a REFERRAL to see a specialist, but your primary care doc is a go-to first
  • REFERRALS for #Medicare Advantage: do you need em? It depends http://1.usa.gov/1iccUkV

 

BENEFITS

 

BROKER

  • Our Twitter #ACA word of the week for June 9-14, 2014
  • #ACA word of the week: BROKER – someone who acts as an intermediary between customers & insurers http://bit.ly/SvkwIL
  • An insurance BROKER receives a commission on the plan he or she sells http://bit.ly/SvkwIL
  • Unlike a navigator, a broker can advise you about which plan is better for you http://bit.ly/SvkwIL
  • Unlike an agent, a BROKER doesn’t represent specific insurance companies http://bit.ly/1hLVEsv
  • How a BROKER can help small businesses get covered http://bit.ly/SUYHDc
  • A handy checklist of info to bring when you see a BROKER for your small business http://bit.ly/1oOmwHW

 

FORMULARY

  • Our Twitter #ACA word of the week for June 16-22, 2014
  • #ACA word of the week: FORMULARY – a list of the drugs covered by your health insurance plan http://bit.ly/1y4gus3
  • Some drugs on the FORMULARY may cost more than others http://bit.ly/1y4gW9x
  • Wondering if your drugs will be covered? Make sure to check your FORMULARY

 

GENERIC DRUGS

  • Our Twitter #ACA word of the week for June 23-29, 2014
  • #ACA word of the week: GENERIC DRUGS – prescription drugs with the same active ingredients as the brand-name drugs http://1.usa.gov/1lK36Ue
  • Why are brand-name drugs more expensive than GENERIC DRUGS? http://bit.ly/V3AhZE
  • Ever wonder how brand-name become GENERIC DRUGS? Here’s how: http://bit.ly/Tm7Vs9
  • Just because it’s not brand-name doesn’t mean it doesn’t work the same – GENERIC DRUGS are a great option!
  • GENERIC DRUGS – same active ingredients, lower price tag

 

SOCIAL WORKER

  • Our Twitter #ACA word of the week for June 30 – July 5, 2014
  • #ACA word of the week: SOCIAL WORKER – a licensed professional who works to improve the lives of individuals http://bit.ly/1qpmzNA
  • Did you know: a renal SOCIAL WORKER helps adjustment to dialysis and transplant http://bit.ly/1rNMxry
  • A SOCIAL WORKER helps plan your discharge from the hospital and follow up care
  • What can a SOCIAL WORKER do for me or my family? @NASWIL http://bit.ly/1m18Mte
  • What can a medical SOCIAL WORKER do for you and your family? http://bit.ly/1pO40ix
  • Hear from an actual SOCIAL WORKER from the Chicago area! http://bit.ly/1pO8QfAJul
  • Why do I need a SOCIAL WORKER? http://bit.ly/1mLwKJN

 

PHYSICAL and OCCUPATIONAL THERAPISTS

  • Our Twitter #ACA word of the week for July 7-13, 2014
  • Wondering why you should care about OCCUPATIONAL THERAPY? These students know why: http://bit.ly/1ziDNPb
  • Medicare therapy caps to PTs, OTs, or SLPs? No worries, exceptions when med necessary! http://1.usa.gov/1ku7QJT
  • Profs and students at USC talk about what it means to be a PHYSICAL THERAPIST http://bit.ly/1mYBLd6
  • Did you know: OCCUPATIONAL THERAPY is one of the best health care jobs! http://bit.ly/1ozGbeM
  • What does a PHYSICAL THERAPIST actually do?
  • How can an OCCUPATIONAL THERAPIST help your child? Here’s how: http://bit.ly/VRaxA8
  • Does Medicare cover PTs, OTs, or SLPs? Here’s some info! http://1.usa.gov/1ku7QJT
  • Here’s an awesome example of what SLPs do: cochlear implant speech therapy! http://bit.ly/1n6knYE
  • Wondering why you should care about OCCUPATIONAL THERAPY? These students know why: http://bit.ly/1ziDNPb

 

DIETITIAN

 

BEHAVIORAL HEALTH PROVIDER

 

MULTIDISCIPLINARY TEAM

 

DENTAL COVERAGE

 

FEE FOR SERVICE

  • Our Twitter #ACA word of the week for August 11-17, 2014
  • #ACA word of the week: FEE FOR SERVICE – when each healthcare service is paid for separately http://1.usa.gov/XQMYIu
  • Does FEE FOR SERVICE help drive up health care costs? http://bit.ly/X9kfhT
  • FEE FOR SERVICE: high cost, mixed quality http://bit.ly/X9kfhT
  • What is the impact on care of shifting from FEE FOR SERVICE to managed Medicaid? http://bit.ly/Vb99Hh

 

IMMUNIZATION

 

MEDICAL LOSS RATIO

  • Our Twitter #ACA word of the week for August 25-31, 2014
  • #ACA word of the week: MEDICAL LOSS RATIO – portion of income from premiums an insurers spends on benefits http://1.usa.gov/1AvbRHz
  • ACA’s MEDICAL LOSS RATIO provision is one that protects consumers http://bit.ly/1qaQdUw
  • MEDICAL LOSS RATIO ensures only 20%-25% of premiums go to administration/marketing costs http://bit.ly/1qaQdUw
  • Breaking down the MEDICAL LOSS RATIO & how it protects your premium dollars http://bit.ly/1pWRGiz
  • MEDICAL LOSS RATIO: insurers pay rebates if they spend less than 80%-85% on benefits http://bit.ly/1pWR9Nu
  • The MEDICAL LOSS RATIO rule is one way the ACA is improving health care by keeping $ on benefits http://bit.ly/1pWRGiz
  • How the ACA’s MEDICAL LOSS RATIO rule is potentially keeping premiums low http://bit.ly/1pWR9Nu
  • ACA’s MEDICAL LOSS RATIO keeps insurer spending transparent: you know where your $ goes http://bit.ly/1pWRGiz

 

OPEN ENROLLMENT

 

DURABLE MEDICAL EQUIPMENT

 

GROUP HEALTH PLAN

 

GUARANTEED ISSUE

 

LONG TERM CARE

 

MEDICARE PART D

 

DONUT HOLE

 

PREAUTHORIZATION

  • Our Twitter #ACA word of the week for October 20-26, 2014
  • #ACA word of the week: PREAUTHORIZATION – a health plan’s decision that a service is medically necessary http://1.usa.gov/1qnyOVh
  • Some but not all services require PREAUTHORIZATION before they are covered http://bit.ly/1tERDeM
  • Brand name medicines that have a generic available often require a PREAUTHORIZATION http://bit.ly/1utLg8H
  • “Pre-approval. PREAUTHORIZATION. Whatever you call it, there are times you need it” http://bit.ly/11X99ic
  • PREAUTHORIZATION is a health plan feature that ensures appropriate use of prescriptions http://bit.ly/10dT0UW
  • PREAUTHORIZATION process complete. It’s over, right? Wrong! You could need a renewal http://bit.ly/11X99ic

 

ASSISTER

 

CONSUMER PROTECTIONS

  • Our Twitter #ACA word of the week for November 3-9, 2014
  • #ACA word of the week: CONSUMER PROTECTIONS – rules safeguarding your access to health insurance & care http://1.usa.gov/1Dms55k
  • Under 26? CONSUMER PROTECTIONS allow you to be covered on your parents’ plan
  • Thanks to CONSUMER PROTECTIONS insurers can’t put annual or lifetime caps on coverage
  • CONSUMER PROTECTIONS put a yearly cap on how much insurers can charge you out-of-pocket
  • Transgender people in Illinois & CONSUMER PROTECTIONS http://1.usa.gov/1yGEWP9
  • Due to CONSUMER PROTECTIONS, insurance companies can’t charge you more based on your gender
  • With CONSUMER PROTECTIONS, you’re guaranteed coverage renewal if you pay your premium
  • The security you get from health reform: CONSUMER PROTECTIONS http://1.usa.gov/1vaXAee

 

COST SHARING REDUCTION

  • Our Twitter #ACA word of the week for November 24-30, 2014
  • #ACA word of the week: COST SHARING REDUCTION – A marketplace plan discount that lowers out-of-pocket costs http://1.usa.gov/1tFWzQ2
  • You can get the COST SHARING REDUCTION only if you enroll in a Silver plan http://1.usa.gov/1BgLKIm
  • The COST SHARING REDUCTION lowers what you pay on deductibles, coinsurance & copays http://1.usa.gov/1BgLKIm
  • “The government pays what?” Read about the ACA’s COST SHARING REDUCTION http://bit.ly/18pveDh
  • Get lower out-of-pockets costs through the COST SHARING REDUCTION http://1.usa.gov/1BgLKIm
  • If your income is below a certain level you may qualify for a COST SHARING REDUCTION http://1.usa.gov/1tFWzQ2
  • Eligibility for a COST SHARING REDUCTION is based on household size & income http://1.usa.gov/1BgLKIm
  • Members of federally recognized tribes may qualify for additional COST SHARING REDUCTIONS

 

PREMIUM TAX CREDIT

  • Our Twitter #ACA word of the week for December 1-7, 2014
  • #ACA word of the week: PREMIUM TAX CREDIT – financial help to pay the monthly cost of health insurance http://1.usa.gov/1aHifAQ
  • The PREMIUM TAX CREDIT can be used right away to lower your monthly premium http://1.usa.gov/1aHifAQ
  • You can use the PREMIUM TAX CREDIT to lower monthly premiums or claim it on your tax return
  • Eligibility for a PREMIUM TAX CREDIT is based on family size & income http://1.usa.gov/127OA2T
  • The poverty level thresholds for the 2014-15 PREMIUM TAX CREDIT http://nerd.me/1vwPAZo
  • Find out if you’re eligible for the PREMIUM TAX CREDIT http://1.usa.gov/127OA2T
  • Calculate your household income to see if qualify for the PREMIUM TAX CREDIT http://bit.ly/13EIis8
  • The PREMIUM TAX CREDIT will decrease if your income goes up, so report income changes http://bit.ly/18pveDh

 

INSURANCE CARRIER

  • Our Twitter #ACA word of the week for December 15-21, 2014
  • #ACA word of the week: INSURANCE CARRIER – the company that provides your health insurance plan
  • Looking for a new INSURANCE CARRIER? Check out this comprehensive list http://bit.ly/1IJx71r
  • Know your INSURANCE CARRIER. Plan benefits & providers matter, but so does the customer experience http://bit.ly/1uwDV8Q
  • All of these folks are INSURANCE CARRIERS @assurantnews @BCBSIL @LLHInsured @health_alliance @Humana @myUHC
  • Compare your INSURANCE CARRIER to others when picking a plan. How does yours stack up? http://bit.ly/1yGWwk8

 

MEDICARE

 

SUMMARY OF BENEFITS AND COVERAGE

  • Our Twitter #ACA word of the week for January 12-18, 2015
  • #ACA word of the week: SUMMARY OF BENEFITS AND COVERAGE – lists what a plan covers & the costs http://1.usa.gov/1y5QDgd
  • Health plans must provide a short, plain-language SUMMARY OF BENEFITS AND COVERAGE http://1.usa.gov/1w17mQk
  • Employers give a SUMMARY OF BENEFITS AND COVERAGE to group coverage eligible employees http://bit.ly/1w17wHk
  • Compiled ACA guidance, regs & info on the SUMMARY OF BENEFITS AND COVERAGE from the DOL http://1.usa.gov/1w18pje

 

APPEAL

  • Our Twitter #ACA word of the week for January 19-15, 2015
  • #ACA word of the week: APPEAL – a consumer’s challenge to an insurer decision not to cover medical services http://1.usa.gov/1yb29Mh
  • You can ask through an APPEAL that your insurance company reconsider its decision http://1.usa.gov/1w18MKA
  • We love @ageoptions‘ & MMW’s materials on how to make a Medicare APPEAL http://bit.ly/1w18VOm

 

MEDICAID

  • Our Twitter #ACA word of the week for February 2-8, 2015
  • #ACA word of the week: MEDICAID – a state-run program that provides medical coverage for low-income populations medicaid.gov
  • How to check the status of you MEDICAID application http://bit.ly/15lEBYp
  • Veterans not eligible for VA healthcare could be MEDICAID eligible http://bit.ly/1yMQoLB
  • MEDICAID provides medical care and long-term care http://bit.ly/1CmatZW
  • To find a MEDICAID provider in your area visit Illinoishealthconnect.com or call 877-912-1999

 

ENROLLMENT

 

WELLNESS VISIT

  • Our Twitter #ACA word of the week for February 16-22, 2015, 2014
  • #ACA word of the week: WELLNESS VISIT – a free doctor visit under Medicare to plan preventive services for the year http://go.cms.gov/15DRH4v
  • What codes to bill for a WELLNESS VISIT? Find out: http://bit.ly/15DRK01
  • Get a yearly free WELLNESS VISIT with Medicare to discuss your plan of preventive care http://bit.ly/1yYEj7J
  • The ACA created the annual WELLNESS VISIT as a Medicare benefit, free to patients http://bit.ly/1xKafqw