Terminology everyone should know

Healthcare Laws & Rights

• COBRA (Consolidated Omnibus Budget Reconciliation Act): A federal law that allows workers and their families to keep their employer-sponsored health insurance for a limited time after a job loss or other qualifying event.

• FMLA (Family and Medical Leave Act): A federal law providing eligible employees with unpaid, job-protected leave for specified family and medical reasons (like childbirth or a serious illness).

• HIPAA (Health Insurance Portability and Accountability Act): A federal law that protects sensitive patient health information from being disclosed without the patient's consent or knowledge.

• ACA (Affordable Care Act): Also known as Obamacare, this comprehensive healthcare reform law aims to make affordable health insurance available to more people.

• ADA (Americans with Disabilities Act): A civil rights law that prohibits discrimination against individuals with disabilities in all areas of public life, including jobs and healthcare access.

Health Insurance & Billing

• HMO (Health Maintenance Organization): A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency.

• PPO (Preferred Provider Organization): A type of health plan where you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost.

• HSA (Health Savings Account): A tax-advantaged savings account available to people with high-deductible health plans to help save for medical expenses.

• FSA (Flexible Spending Account): A special account you put money into that you use to pay for certain out-of-pocket healthcare costs, usually set up through an employer.

• EOB (Explanation of Benefits): A statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf.

• OOPM (Out-of-Pocket Maximum): The absolute most you have to pay for covered healthcare services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits.

• CHIP (Children’s Health Insurance Program): A program that provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid but not enough to buy private insurance.

Medical Care & Records

• PCP (Primary Care Physician): Your main healthcare provider for non-emergency situations, regular check-ups, and referrals to specialists.

• EHR / EMR (Electronic Health Record / Electronic Medical Record): Digital versions of a patient's paper chart, allowing information to be shared across different healthcare settings.

• Rx (Prescription): Derived from the Latin word "recipe," this abbreviation is used to denote a medical prescription.

• OTC (Over-The-Counter): Medicines you can buy without a prescription from a doctor.

Organizations & Agencies

• CMS (Centers for Medicare & Medicaid Services): The federal agency that runs the Medicare, Medicaid, and Children’s Health Insurance Programs.

• CDC (Centers for Disease Control and Prevention): The national public health agency of the United States, focused on protecting public health and safety through the control and prevention of disease.

• FDA (Food and Drug Administration): A federal agency responsible for protecting public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices.

• WHO (World Health Organization): A specialized agency of the United Nations responsible for international public health.