Insurance program jointly funded by state and Federal government that provides health insurance to low-income children and, in some states, pregnant women in families who earn too much income to qualify for Medicaid but cannot afford to purchase private health insurance coverage.
An integrated care approach to managing illness which includes screenings, check-ups, monitoring and coordinating treatment and patient education. If you have a chronic disease, this approach can improve your quality of life while reducing your health care costs by preventing or minimizing the effects of the disease.
The percentage of allowed charges for covered services that you’re required to pay. For example, the health insurance may cover 80 percent of charges for a covered hospitalization, leaving you responsible for the other 20 percent. This 20 percent is known as the co-insurance.
A Federal law that may allow you to temporarily keep health coverage after your employment ends, you lose coverage as a dependent of the covered employee, or another qualifying event occurs. If you elect COBRA coverage, you pay 100 percent of the premiums, including the share the employer used to pay, plus a small administrative fee. Because of the subsidies available, Covered California plans may be cheaper than COBRA coverage.
The ability, in some states, to switch your job-based coverage to an individual policy when you lose eligibility for job-based coverage. Family members not covered under a job-based policy may also be able to convert to an individual policy if they lose dependent status (for example, after a divorce).
The share of costs covered by your insurance that you pay out of your own pocket. This term generally includes deductibles, coinsurance and copayments or similar charges, but it doesn’t include premiums, balance billing amounts for non-network providers or the cost of non-covered services. Cost sharing in Medicaid and CHIP also includes premiums.
Health insurance coverage under any of the following: a group health plan; individual health insurance; student health insurance; Medicare; Medicaid; CHAMPUS and TRICARE; the Federal Employees Health Benefits Program; Indian Health Service; the Peace Corps; Public Health Plan (any plan established or maintained by a State, the U.S. government or a foreign country); Children’s Health Insurance Program (CHIP); or a state health insurance high-risk pool. If you have prior creditable coverage, it will reduce the length of a pre-existing condition exclusion period under new job-based coverage.