Health Insurance Glossary
Health insurance terms, explained simply
Definitions from HealthCare.gov, paired with practical context so you can pick a plan that actually fits. Use search to find a term, or browse the full list below. Understand deductibles, premiums, copays, HMOs, PPOs, and everything in between.
Showing 24 of 256 health insurance terms
GeneralIndividual Coverage Health Reimbursement Arrangement
A type of Health Reimbursement Arrangement that reimburses medical expenses, like monthly premiums, and requires eligible employees and…
GeneralCo-op
A non-profit organization in which the same people who own the company are insured by the company. Cooperatives can be formed at a…
GeneralNotice
An official form of communication that informs individuals about the status of their applications, their eligibility for programs, or other…
GeneralPlan ID
Each Marketplace health plan has a unique 14-character identifier that's a combination of numbers and/or letters.
GeneralPreferred Provider Organization (PPO)
A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers.…
GeneralCost sharing
The share of costs covered by your insurance that you pay out of your own pocket. This term generally includes deductibles, coinsurance,…
GeneralNavigator
An individual or organization that's trained and able to help consumers, small businesses, and their employees as they look for health…
GeneralSmall Business Health Options Program (SHOP)
The Small Business Health Options Program (SHOP) helps small business owners provide medical and/or dental insurance to their employees.…
GeneralEligible immigration status
An immigration status that's considered eligible for getting health coverage through the Marketplace. The rules for eligible immigration…
GeneralDependent coverage
Insurance coverage for family members of the policyholder, such as spouses, children, or partners.
GeneralEmergency room care
Emergency services you get in an emergency room.
MedicareMedicare Part D
A program that helps pay for prescription drugs for people with Medicare who join a plan that includes Medicare prescription drug coverage.…
GeneralWorker's compensation
An insurance plan that employers are required to have to cover employees who get sick or injured on the job.
GeneralSocial Security benefits
The amount you get from Social Security Disability, Retirement (including Railroad retirement), or Survivor's Benefits each month.
GeneralExcluded services
Health care services that your health insurance or plan doesn’t pay for or cover.
GeneralPre-existing Condition Insurance Plan (PCIP)
A program (that no longer exists) created by the Affordable Care Act to provide a health coverage option if you were uninsured for at least…
GeneralEmergency medical condition
An illness, injury, symptom or condition so serious that a reasonable person would seek care right away to avoid severe harm.
GeneralCourt awards
Money that's due to you as the result of a lawsuit. This money may be taxable. Examples of lawsuit proceeds that aren't taxable are amounts…
GeneralDependent
A child or other individual for whom a parent, relative, or other person may claim a personal exemption tax deduction. Under the Affordable…
GeneralNetwork
The facilities, providers and suppliers your health insurer or plan has contracted with to provide health care services.
GeneralDisability
A limit in a range of major life activities. This includes activities like seeing, hearing, walking and tasks like thinking and working.…
GeneralPension (retirement benefit)
A payment or series of payments made to you after you retire from work. Generally, the amount of your income from a pension or retirement…
GeneralAnnual deductible combined
Usually in Health Savings Account (HSA) eligible plans, the total amount that family members on a plan must pay out-of-pocket for health…
GeneralAffordable coverage
In 2026, a job-based health plan is considered "affordable" if your share of the monthly premium for the lowest-cost plan offered by the…
Showing 1–24 of 256 results
Common Questions About Health Insurance Terms
Health Insurance Definitions by State
Health insurance rules, marketplace plans, and Medicaid eligibility vary by state. Explore state-specific guides to understand how terms apply where you live.
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