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Accountable Care Organization

A group of health care providers who give coordinated care, chronic disease management, and improve the quality of patient care. The organization can afford to offer lower cost care by maintaining a high quality of health care standards.

Actuarial Value

The percentage of total average costs for benefits covered by a health policy.

Actuary

A professional (accountant working for an insurance company) who determines how much the company should charge for premiums. This is heavily based on the number of claims paid versus the amount of premiums generated.

Admitting Privilege

An admitting privilege is a doctor’s right to admit patients to a specific hospital.

Advance Directive

An advance directive designates an individual to make health care decisions on your behalf if you are physically or mentally unable to do so personally.

Advocacy

Any activity done with the intent of helping an individual or a group receive something they need or want.

Affordable Care Act (ACA)

The comprehensive health care reform law enacted in March 2010. The health reform law was created in two parts: The Patient Protection Act and Affordable Care Act, which was signed and made effective on March 23, 2010, and was amended by the Health Care and Education Reconciliation Act several days later. The Affordable Care Act refers to the final, amended version of the law.

Agent

A salesperson with a license to sell policies for one or more health insurance companies.

Allowed Charge

A discounted rate that insurance companies will accept and pay for covered benefits. Insurance companies discuss these discounts with health care providers, and the providers agree to take the allowed charge as a full payment. Allowed charges vary with every insurance company.

Annual Limit

A limit, or cap, on the benefits your insurer pays per year while you have one of their health insurance plans.

Association

Associations offer group health insurance policies that allow employees to customize their plans, and have purchasing power with insurers because there is a larger pool of policy-holders in a group.

 

Sources:

1. HealthInsurance.org, “Health insurance glossary”. http://www.healthinsurance.org/glossary/

2. HealthCare.gov, “Glossary – A”. http://www.healthcare.gov/glossary/a/index.html