Health Insurance terms starting with P

43 terms

Patient Protection and Affordable Care Act See Affordable Care Act
Patient Protection and Affordable Care Act (PPACA) Legislation (Public Law 111-148) signed by President Obama on March 23, 2010. One of two laws collectively referred to as the Affordable Care Act or…
Patient-Centered Outcomes Research Research that compares different medical treatments and interventions to provide evidence on which strategies are most effective in different populations…
Payment Bundling A payment structure in which different health care providers who are treating you for the same or related conditions are paid an overall sum for taking…
Payment Frequency You can choose how often you would like to pay your insurance premiums. If you choose “monthly,” your premium payments will be due every month.
Penalty See Fee
Pension (Retirement Benefit) A payment or series of payments made to you after you retire from work. Generally, the amount of your income from a pension or retirement account…
Physician Services Health care services a licensed medical physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine) provides or coordinates.
Plan A benefit your employer, union or other group sponsor provides to you to pay for your health care services.
Plan Year A 12-month period of benefits coverage under a group health plan. This 12-month period may not be the same as the calendar year.
Platinum Health Plan See Health Plan Categories
Point of Service (POS) Plans A type of plan in which you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network.
Point-of-Service Plan (POS) A type of managed care plan combining features of health maintenance organizations (HMOs) and preferred provider organizations (PPOs), in which…
Policy The contract form issued by the company to explain the coverage provided. It is a legal document.
Policy Year A 12-month period of benefits coverage under an individual health insurance plan. This 12-month period may not be the same as the calendar year.
Portability Portability is a provision of the INA intended to preserve the legal status of an H-1B worker who is already in the U.S.
Pre-authorization Some insurance companies require authorization from them before they will pay for medical services like hospitalization or surgery.
Pre-existing Condition A pre-existing condition is a health problem that you already have when you apply for insurance.
Pre-Existing Condition (Job-based Coverage) Any condition (either physical or mental) including a disability for which medical advice, diagnosis, care, or treatment was recommended or received…
Pre-existing condition exclusion The period of time that an individual receives no benefits under a health benefit plan for an illness or medical condition for which an individual…
Pre-Existing Condition Exclusion Period (Individual Policy) The time period during which an individual policy won't pay for care relating to a pre-existing condition.
Pre-Existing Condition Exclusion Period (Job-based Coverage) The time period during which a health plan won't pay for care relating to a pre-existing condition.
Pre-existing Condition Insurance Plan (PCIP) A program that will provide a health coverage option for you if you have been uninsured for at least six months, you have a pre-existing condition, and…
Preauthorization A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically…
Preferred Provider A provider who has a contract with your health insurer or plan to provide services to you at a discount.
Preferred Provider Organization (PPO) A preferred provider organization (PP0) is a network of doctors and other healthcare providers that offers discounted care to members of a sponsoring…
Premium The price charged for insurance.
Premium Tax Credit The Affordable Care Act provides a new tax credit to help you afford health coverage purchased through the Marketplace.
Prescription Drug You must have a doctor's prescription to receive a prescription drug.
Prescription Drug Coverage Health insurance or plan that helps pay for prescription drugs and medications.
Prescription Drugs Drugs and medications that, by law, require a prescription.
Prevention Activities to prevent illness such as routine check-ups, immunizations, patient counseling, and screenings.
Preventive Under the law, all health plans must cover certain preventive health services. Routine health care that includes screenings, checkups, and patient…
Preventive Medicine Health care designed to prevent disease or discover and treat disease in the early stage.
Preventive Services Routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems.
Primary Care Health services that cover a range of prevention, wellness, and treatment for common illnesses.
Primary Care Physician A physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine) who directly provides or coordinates a range of health care services for…
Primary Care Physician (PCP) Your Primary Care Physician ("PCP") is the doctor you choose to provide basic health care.
Primary Care Provider A physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine), nurse practitioner, clinical nurse specialist or physician assistant, as…
Prior Authorization Approval from a health plan that may be required before you get a service or fill a prescription in order for the service or prescription to be covered by…
Provider Any person or place that provides health care or prescription drugs. Providers can be doctors, hospitals, pharmacies, chiropractors, etc.
Provider Category The category listed is the medical specialty for the health care practitioner, such as internal medicine or neurology.
Public Health A field that seeks to improve lives and the health of communities through the prevention and treatment of disease and the promotion of healthy behaviors…