Glossary
Plain-language definitions of insurance terms.
- POS Plan
- A Point of Service plan blends HMO and PPO features: you pick a primary care doctor and need referrals, but you also get limited out-of-network coverage.
- PPO
- A Preferred Provider Organization is a health plan that lets you see specialists without a referral and covers some out-of-network care, usually at a higher cos...
- Preauthorization
- Approval a health plan may require before it will cover certain services, procedures, or drugs. Skipping it can lead to a denied claim.
- Premium Tax Credit
- A federal subsidy that can lower the monthly premium for a health plan bought through the Marketplace, based on household income and size.
- Provider Network
- The group of doctors, hospitals, and other providers that have contracted with a health plan to deliver care at negotiated rates. Care from in-network providers...
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