HEALTH CARE PROVIDER:
A doctor, hospital, laboratory, nurse, or anyone who delivers medical or health-related care.
HEALTH EMPLOYER DATA AND INFORMATION SET:
A set of standard performance measures that provides information about the quality of a health plan. These measures are used to compare managed care plans.
HEALTH INSURANCE PORTABILITY & ACCOUNTABILITY ACT:
A law passed in 1996, which is also called the “Kassebaum-Kennedy” law. This law expanded health care coverage for persons who have lost their job, or move from one job to another. HIPAA protects persons who have pre-existing medical conditions, and/or problems, based on past or present health, in getting health insurance coverage.
HEALTH MAINTENANCE ORGANIZATION:
Prepaid health plans which cover doctors’ visits, hospital stays, emergency care, surgery, preventive care, checkups, lab tests, X-rays, and therapy. In a HMO, one must choose a primary care physician who coordinates all care and makes referrals to any specialists that may be required. In a HMO, one must use the doctors, hospitals and clinics that participate in your plan’s network. No benefits are paid for non-emergency benefits provided outside the HMO network.
HIGH DEDUCTIBLE HEALTH PLAN (HDHP):
A person must be enrolled in a qualified High-Deductible Health Plan (HDHP) before they can establish a Health Savings Account (HSA). Not all high-deductible health plans qualify for purposes of establishing HSA eligibility. A qualified HDHP benefit design must conform to various federally-mandated requirements, such as a minimum $1000 deductible and a lack of first-dollar benefit provisions.
HEALTH SAVINGS ACCOUNT:
Operating similarly to IRAs, HSAs are tax-advantaged savings accounts for health care services. A person must enroll in a qualified High-Deductible Health Plan (HDHP) before they can establish an HSA.
HOME HEALTH CARE:
Services given at home to aged, disabled, sick, or convalescent individuals not needing institutional care. The most common types of home care are visiting nurse services and speech, physical, occupational, and rehabilitation therapy. These services are provided by home health agencies, hospitals, or other community organizations.
Care for the terminally ill and their families, in the home or a non-hospital setting, that emphasizes alleviating pain rather than a medical cure.
Reimbursement for both inpatient and outpatient medical care expenses incurred in a hospital. Inpatient Benefits include; Charges for room and board, charges for necessary services and supplies sometimes referred to as ‘hospital extras,’ ‘other hospital extras,’ ‘miscellaneous charges,’ and ‘ancillary charges. Outpatient Benefits include; surgical procedures, rehabilitation therapy, and physical therapy.
A form of health insurance that offers coverage of certain costs related to hospitalization and surgical procedures. A hospital-surgical plan does not cover other types of medical services, such as physician office visits and outpatient prescription drugs.