A term that refers to the role of the primary care doctor in an HMO plan. Because of the nature of an HMO, the primary care physician acts as the main operating force in the patient’s care. All treatment from other providers must be approved and require referrals from their main doctor.
A medication that contains the same ingredients as a prescription with a brand name, but can be purchased for a fraction of the cost and produced by other manufacturers when the brand name drug’s patent has expired.
A time period following the due date to pay for your insurance when your coverage is still active and you can make a payment without being penalized for lateness.
Grandfathered Health Plan
A grandfathered plan is a group health insurance policy created or an individual plan purchased on or before March 23, 2010. Grandfathered plans are not affected by many of the changes imposed by the Affordable Care Act. Plans can lose their “grandfathered” status if they change the plan to cut benefits or increase costs to customers or employees.
Group Health Insurance
A health insurance plan that is provided by a business or organization as a benefit for its members or workers.
Insurance coverage that must be given to a client regardless of age, gender, health status, or other factors that might indicate use of medical services. In some states, guaranteed issue does not limit the amount of premiums and other charges you will incur if you are enrolled.
Insurance companies are required to offer to renew your health plan if you have paid your premiums and not violated your policy. This is enforced under the Guaranteed Renewability Provision.
1. eHealthInsurance.com, “Health insurance glossary”. http://www.ehealthinsurance.com/health-insurance-glossary/terms-g/
2. HealthCare.gov, “Glossary – G”. http://www.healthcare.gov/glossary/g/index.html