Health Insurance Glossary

HIPAA (Health Insurance Portability and Accountability Act of 1996):: Legislation mandating specific privacy rules and practices for medical care providers and health insurance companies, designed to streamline the healthcare and insurance industries and to protect the privacy and identity of healthcare consumers. HIPAA also provides additional protections for consumers, designed to help them obtain or retain health insurance coverage in certain circumstances. For more information on HIPAA rules and regulations, visit the Centers for Medicare and Medicaid Services website at http://www.cms.hhs.gov.

HMO:: HMO means "Health Maintenance Organization." HMO plans offer a wide range of health care services through a network of providers that contract exclusively with the HMO, or who agree to provide services to members at a pre-negotiated rate. As a member of an HMO, you will need to choose a primary care physician ("PCP") who will provide most of your health care and refer you to HMO specialists as needed. Some HMO plans require that you fulfill a deductible before services are covered. Others only require you to make a copayment when services are rendered. Health care services obtained outside of the HMO are typically not covered, though there may be exceptions in the case of an emergency.

An HMO may be right for you if:

You're willing to play by the rules and coordinate your care through a primary care physician
You're looking for comprehensive benefits at a reasonable monthly premium
You value preventive care services: coverage for checkups, immunizations and similar services are often emphasized by HMOs

HSA (Health Savings Account):: A tax advantaged savings account to be used in conjunction with certain high-deductible (low premium) health insurance plans to pay for qualifying medical expenses. Contributions may be made to the account on a tax-free basis. Funds remain in the account from year to year and may be invested at the discretion of the individual owning the account. Interest or investment returns accrue tax-free. Penalties may apply when funds are withdrawn to pay for anything other than qualifying medical expenses. Click here for more information on HSAs.

Health Care Financing Administration (HCFA):: See the Centers for Medicare and Medicaid Services.

Health Service Agreement:: An agreement between an employer and a health insurance company outlining benefits, enrollment procedures, eligibility standards, etc.

High Deductible Health Plan (HDHP):: A type of health insurance plan that, compared to traditional health insurance plans, requires greater out-of-pocket spending, although premiums may be lower. In 2018, an HSA-qualifying HDHP must have a deductible of at least $1,350 for single coverage and $2,700 for family coverage. The plan must also limit the total amount of out-of-pocket cost-sharing for covered benefits each year to $6,650 for single coverage and $13,300 for family coverage.

Home Health Agency:: A certified healthcare agency that provides home health care services. See, Home Health Care.

Home Health Care:: Part-time care that is provided by medical professionals in the home setting rather than in a hospital or skilled nursing facility.

Hospice Care:: Care rendered either on an inpatient basis or in the home setting for a terminally ill patient. Often referred to as "palliative" or "supportive" care, hospice care emphasizes the management of pain and discomfort and the emotional support of the patient and family. See also, Respite Care.

Hospital Benefits:: Benefits payable for hospital room and board and other miscellaneous charges resulting from hospitalization.

Hospitalization:: Typically, hospitalization services include services related to staying at a hospital for either scheduled procedures, accidents or medical emergencies. Hospitalization services typically do not include hospital stays for giving birth to a child.

Hospitalization Insurance:: Insurance intended to provide coverage in case of hospitalization, including benefits for room and board and miscellaneous expenses, within certain limitations.

please note, however, that definitions of certain terms may vary across insurance companies.

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