Quality ratings (“star” ratings)
Ratings range from 1-5 stars to help you compare Marketplace plans.
Federal poverty level (FPL)
A measure of income issued every year by the Department of Health and Human Services (HHS). Federal poverty levels are used to determine your eligibility for certain programs and benefits, including savings on Marketplace health insurance, and Medicaid and CHIP coverage.
Annual limit
A cap on the benefits your insurance company will pay in a year while you’re enrolled in a particular health insurance plan. These caps are sometimes placed on particular services such as prescriptions or hospitalizations. Annual limits may be placed on the dollar amount of covered services or on the number of visits that will […]
Urgent care
Care for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not so severe it requires emergency room care.
Community rating
A rule that prevents health insurers from varying premiums within a geographic area based on age, gender, health status or other factors.
Family and Medical Leave Act (FMLA)
A federal law that guarantees up to 12 weeks of job protected leave for certain employees when they need to take time off due to serious illness or disability, to have or adopt a child, or to care for another family member. When on leave under FMLA, you can continue coverage under your job-based plan.
Hospice services
Services to provide comfort and support for persons in the last stages of a terminal illness and their families.
Plan
A benefit your employer, union or other group sponsor provides to you to pay for your health care services.
Medicaid
Insurance program that provides free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Many states have expanded their Medicaid programs to cover all people below certain income levels.
Skilled nursing care
Services from licensed nurses in your own home or in a nursing home. Skilled care services are from technicians and therapists in your own home or in a nursing home.