Glossary |
Our glossary of terms explains the jargon and defines the common acronyms you will come across at Health Care Reform Plans. Please email us at
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| Guaranteed eligibility | Guaranteed eligibility is a term that, in reference to insurance coverage, means that an individual cannot be turned away by an insurer because of an illness or pre-existing condition. (See Guaranteed issue health insurance.)
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| Guaranteed issue health insurance | Guaranteed issue health insurance plans are those that, per state and federal legislation, are available to individuals regardless of their medical condition or health history.
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| Health Maintenance Organizations (HMOs) | Health Maintenance Organizations (HMOs) (See Managed care plans.)
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| Health Reimbursement Arrangement (HRA) | A Health Reimbursement Arrangement (HRA) provides employees with coverage for certain medical expenses; the funds are provided not by the employee but by the employer, which receives a tax credit for offering the program.
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| Health Savings Account (HSA) | A Health Savings Account (HSA) is a medical savings account, first made available in 2003 to U.S. taxpayers (under the Medicare Prescription Drug, Improvement, and Modernization Act). HSAs are especially geared toward those with high-deductible insurance policies and can be used for medical and even nonmedical expenses. Money deposited in an HSA is not subject to income tax, and unused funds can roll over each year. Proponents of HSAs believe that they encourage people to save money, to adopt high-deductible plans, and to become more responsible for their own healthcare choices. Critics of these plans argue that consumers end up making unwise choices between healthcare is such a complicated issue.
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| healthcare delivery system | A healthcare delivery system is the organization through which healthcare is provided and the method through which it is paid for. In the United States, healthcare can be financed and provided privately (that is, purchased directly by an individual or through an employer) or publicly (by the government). Examples of publicly provided and funded systems are Medicare and Medicaid.
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| individual mandate | An individual mandate is a requirement that individuals purchase healthcare insurance. Those who do not purchase insurance are penalized—for example, in the case of Massachusetts’ universal healthcare plan (which started on July 1, 2007), individuals who do not purchase health insurance lose their personal state tax exemption for that year.
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| Individuals with Disabilities Education | The Individuals with Disabilities Education Act (IDEA) is a law passed to ensure services to children with disabilities throughout the United States. “IDEA governs how states and public agencies provide early intervention, special education, and related services to more than 6.5 million eligible infants, toddlers, children and youth with disabilities.” (See idea.ed.gov.)
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| Institute of Medicine (IOM) | The Institute of Medicine (IOM) of the National Academy of Science is a nonprofit organization founded in 1970 that provides “science-based advice on matters of biomedical science, medicine, and health.” As an entity outside of the government, the IOM strives to provide “unbiased, evidence-based” information and advice about health and science to “policy-makers, professionals, leaders in every sector of society, and the public at large.” (See iom.edu.)
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| Managed care plans | Managed care plans are health insurance plans that provide reduced-cost care for members by setting up a network of medical providers and facilities. Types of managed care plans include Health Maintenance Organizations (HMOs), which typically cover only care obtained from within the network; Preferred Provider Organizations (PPOs), which typically cover care both inside and outside of the network, with more paid for in-network care; and Point of Service (POS) plans, which allow members to choose between an HMO or PPO each time they need care. Managed care, which came into play during the Reagan years in the United States, was originally aimed at reducing Medicare payouts.
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