Health insurance and Obamacare terms

What does health reform mean to you? Start with these definitions.

C

capitation

Capitation represents a set dollar limit that you or your employer pay to a health maintenance organization (HMO), regardless of… Read more

carrier

The insurance company or HMO offering a health plan.

catastrophic plan

In addition to the Platinum, Gold, Silver and Bronze individual health insurance plans that were available starting in 2014, the… Read more

certificate of insurance

The certificate of insurance is a printed description of the benefits and coverage provisions forming the contract between the carrier… Read more

claim

A claim is an application for benefits provided by your health plan. You must file a claim before funds will… Read more

CO-OP

See Consumer Operated and Oriented Plan.

COBRA

COBRA is the Consolidated Omnibus Budget Reconciliation Act of 1985, federal legislation that allows you – if you work for… Read more

coinsurance

Coinsurance refers to money that an individual is required to pay for services, after a deductible has been paid. Coinsurance… Read more

community rating

Community rating refers to an insurance pricing system that prohibits medical underwriting and requires that all of a carrier's insureds… Read more

comprehensive coverage

Comprehensive coverage – also known as major medical health insurance – refers to plans that cover a wide range of… Read more

Consumer Operated and Oriented Plan (CO-OP)

Created by the Affordable Care Act, the CO-OP program was designed to help create nonprofit, member-controlled health insurance plans that… Read more

cooperatives

Cooperatives or insurance cooperatives were proposed in the Senate as an alternative to a proposed government plan or public option.… Read more

copayment

Copayment is a predetermined (flat) fee that an individual pays for health care services, in addition to what the insurance… Read more

cost-sharing subsidies

Cost-sharing subsidies are subsidies that are paid directly from the federal government to the insurer in order to reduce maximum… Read more

credit for prior coverage

Credit for coverage may or may not apply when you switch employers or insurance plans. A pre-existing condition waiting period… Read more

critical-illness plan

A critical-illness plan is a policy that pays the insured a lump sum following the diagnosis of an illness covered… Read more