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['glossary']
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['glossary']
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[]
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Canceled Debts
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Deudas canceladas
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/glossary/cancelled-debts/
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Si usted tuvo una deuda por un préstamo o al comprar algo a crédito, y una parte de la cantidad que debe se descuenta o es perdonada ("cancelada"), la cantid...
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If you incurred a debt from a loan or from buying something on credit and a portion of the amount you owe is discharged or forgiven ("canceled"), the amount ...
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['glossary']
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['glossary']
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[]
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Bronze Health Plan
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Plan médico de categoría Bronce
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/glossary/bronze-health-plan/
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Una de las 4 categorías de plan (también conocidas como “nivel de metal”) en el Mercado de Seguros Médicos. Los planes Bronce por lo general tienen primas me...
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One of 4 plan categories (also known as “metal levels”) in the Health Insurance Marketplace®. Bronze plans usually have the lowest monthly premiums but the h...
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['glossary']
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['glossary']
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Broker
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Corredor (de seguros)
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/glossary/broker/
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Un agente o corredor de seguros es una persona o empresa que puede ayudarle a solicitar ayuda para pagar por su cobertura, e inscribirse en un Plan Médico Ca...
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An agent or broker is a person or business who can help you apply for help paying for coverage and enroll in a Qualified Health Plan (QHP) through the Market...
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['glossary']
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['glossary']
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[]
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Brand Name (Drugs)
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Medicamentos de marca
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/glossary/brand-name-drugs/
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Un medicamento vendido por una compañía farmacéutica con un nombre o marca comercial específica y que se encuentra protegido por una patente. Los medicamento...
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A drug sold by a drug company under a specific name or trademark and that is protected by a patent. Brand name drugs may be available by prescription or over...
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['glossary']
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['glossary']
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[]
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Authorized Representative
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Representante autorizado
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/glossary/authorized-representative/
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Una persona que usted escoja para actuar en su nombre en el Mercado de seguros, tal como un miembro de su familia u otra persona de confianza. Algunos repres...
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Someone who you choose to act on your behalf with the Marketplace, like a family member or other trusted person. Some authorized representatives may have leg...
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['glossary']
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['glossary']
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[]
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Attest/Attestation
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Atestiguar/Certificación
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/glossary/attest-attestation/
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Cuando usted solicita cobertura médica a través del Mercado de seguros, está obligado a dar fe de (o "certificar") la veracidad de la información proveída al...
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When you apply for health coverage through the Marketplace, you're required to agree (or "attest") to the truth of the information provided by signing the ap...
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['glossary']
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['glossary']
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[]
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Annual Deductible Combined
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Deducible anual combinado
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/glossary/annual-deductible-combined/
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Por lo general, en los planes elegibles de Cuentas de Ahorros Médicos (HSA en inglés), es la cantidad total que los miembros de la familia en un plan deben g...
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Usually in Health Savings Account (HSA) eligible plans, the total amount that family members on a plan must pay out-of-pocket for health care or prescription...
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['glossary']
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['glossary']
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[]
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Alimony
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Pensión alimenticia
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/glossary/alimony/
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La pensión alimenticia es el dinero que obtiene de un cónyuge con quien uno ya no vive, o un ex cónyuge, si se paga como parte de un acuerdo de divorcio, acu...
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Alimony is money you get from a spouse with whom you no longer live, or a former spouse, if paid to you as part of a divorce agreement, separation agreement,...
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['glossary']
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['glossary']
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[]
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Agent and Broker (Health Insurance)
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Agente y Corredor (Seguro Médico)
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/glossary/agent/
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Un profesional de seguro entrenado que puede ayudarlo a inscribirse en un seguro médico. Los agentes pueden trabajar para una sola compañía de seguros médico...
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A trained insurance professional who can help you enroll in a health insurance plan. Agents may work for a single health insurance company; brokers may repre...
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['glossary']
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['glossary']
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[]
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Advance Premium Tax Credit (APTC)
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Crédito fiscal anticipado para las primas
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/glossary/advanced-premium-tax-credit/
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Un crédito fiscal que puede recibir por adelantado para reducir su pago mensual de seguro médico (o “prima”). Cuando solicita la cobertura en el Mercado de S...
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A tax credit you can take in advance to lower your monthly health insurance payment (or “premium”). When you apply for coverage in the Health Insurance Marke...
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['glossary']
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['glossary']
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[]
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Accreditation
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Acreditación
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/glossary/accreditation/
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Si un plan de salud del Mercado de seguros es aprobado, significa que una organización independiente le ha dado el "sello de aprobación" para demostrar que e...
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If a Marketplace health plan is approved, this is the “seal of approval” given to the plan by an independent organization to show that the plan meets nationa...
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['glossary']
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['glossary']
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[]
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Wellness Programs
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Programas de bienestar
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/glossary/wellness-programs/
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Un programa diseñado para mejorar y promover la salud y el buen estado físico que generalmente se ofrece a través del lugar de trabajo, aunque los planes de ...
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A program intended to improve and promote health and fitness that's usually offered through the work place, although insurance plans can offer them directly ...
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['glossary']
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['glossary']
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[]
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Well-baby and Well-child Visits
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Consultas de prevención para bebés y niños
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/glossary/well-baby-and-well-child-visits/
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Visitas médicas de rutina por servicios médicos preventivos que se hacen cuando un bebé es joven, así como visitas anuales hasta que el niño cumpla 21 años. ...
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Routine doctor visits for comprehensive preventive health services that occur when a baby is young and annual visits until a child reaches age 21. Services i...
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['glossary']
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['glossary']
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[]
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Waiting Period (Job-based coverage)
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Periodo de espera (cobertura a través de un empleador)
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/glossary/waiting-period-job-based-coverage/
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El periodo de tiempo que debe transcurrir hasta que sea efectiva la cobertura de un empleado o dependiente, el cual de cualquier otro modo, sea elegible para...
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The time that must pass before coverage can become effective for an employee or dependent who is otherwise eligible for coverage under a job-based health plan.
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['glossary']
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['glossary']
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[]
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Value-Based Purchasing (VBP)
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Compra basada en la calidad (VBP en inglés)
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/glossary/value-based-purchasing-vbp/
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Conexión de los pagos a los proveedores con las mejoras en su rendimiento. Esta forma de pago responsabiliza a los proveedores de cuidados médicos en cuanto ...
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Linking provider payments to improved performance by health care providers. This form of payment holds health care providers accountable for both the cost an...
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['glossary']
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['glossary']
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[]
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Urgent Care
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Cuidados de urgencia
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/glossary/urgent-care/
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Cuidados de una enfermedad, lesión, o condición tan grave, que cualquier persona razonable buscaría atención de inmediato, pero no tan graves como para neces...
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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.
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['glossary']
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['glossary']
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[]
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Uncompensated Care
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Cuidados no compensados
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/glossary/uncompensated-care/
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Cuidados o servicios médicos facilitados por hospitales o proveedores de cuidados médicos, que no son reembolsados. A menudo, los cuidados no compensados sur...
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Health care or services provided by hospitals or health care providers that don't get reimbursed. Often uncompensated care arises when people don't have insu...
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['glossary']
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['glossary']
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[]
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UCR (Usual, Customary, and Reasonable)
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Usual, acostumbrado, y razonable (UCR en inglés)
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/glossary/ucr-usual-customary-and-reasonable/
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La cantidad pagada por un servicio médico en un área geográfica en base a lo que los proveedores de esa área cobran usualmente por ese servicio médico o por ...
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The amount paid for a medical service in a geographic area based on what providers in the area usually charge for the same or similar medical service. The UC...
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['glossary']
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['glossary']
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[]
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State Continuation Coverage
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Continuidad de la cobertura por el estado
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/glossary/state-continuation-coverage/
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Un requisito estatal similar a COBRA que se aplica a las pólizas de seguro médico de grupo de aquellos empleadores con menos de 20 empleados. En algunos esta...
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A state-based requirement similar to COBRA that applies to group health insurance policies of employers with fewer than 20 employees. In some states, state c...
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['glossary']
|
['glossary']
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[]
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Specialist
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Especialista
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/glossary/specialist/
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Un médico especialista que se dedica en una área específica de la medicina o en un grupo específico de pacientes, para diagnosticar, administrar, prevenir, o...
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A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and cond...
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['glossary']
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['glossary']
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[]
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Special Health Care Need
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Necesidades de cuidado médico especial
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/glossary/special-health-care-need/
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Las necesidades de cuidado médico y asuntos relacionados, de niños que tienen enfermedades crónicas de tipo físicas, del desarrollo, del comportamiento o emo...
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The health care and related needs of children who have chronic physical, developmental, behavioral or emotional conditions. Such needs are of a type or amoun...
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['glossary']
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['glossary']
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[]
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Special Enrollment Period (SEP)
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Período especial de inscripción (SEP)
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/glossary/special-enrollment-period/
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Fuera del Período de Inscripción Abierta anual en el que puede inscribirse en un seguro médico. Usted califica para un Período Especial de Inscripción si ha ...
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A time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you’ve had certain...
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['glossary']
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['glossary']
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[]
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Skilled Nursing Facility Care
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Cuidados en centros de enfermería especializada
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/glossary/skilled-nursing-facility-care/
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Servicios de atención y rehabilitación de enfermería especializada ofrecidos de manera continua y diaria en un centro de enfermería especializada. Ejemplos d...
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Skilled nursing care and rehabilitation services provided on a continuous, daily basis in a skilled nursing facility. Examples of skilled nursing facility ca...
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['glossary']
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['glossary']
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[]
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Skilled Nursing Care
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Cuidados de enfermería especializada
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/glossary/skilled-nursing-care/
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Servicios que son recibidos de enfermeras registradas en su hogar o en una residencia para ancianos. Los servicios de cuidados especializados son los recibid...
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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 nursi...
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['glossary']
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['glossary']
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[]
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Self-Insured Plan
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Plan de seguro propio
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/glossary/self-insured-plan/
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Tipo de plan que generalmente existe en las compañías más grandes, donde el propio empleador recolecta las primas de los afiliados y asume la responsabilidad...
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Type of plan usually present in larger companies where the employer itself collects premiums from enrollees and takes on the responsibility of paying employe...
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['glossary']
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['glossary']
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[]
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Risk Adjustment
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Ajuste de riesgos
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/glossary/risk-adjustment/
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Proceso estadístico que tiene en cuenta el estado de salud subyacente y el gasto en salud de los afiliados en un plan de seguro, a la hora de calcular los re...
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A statistical process that takes into account the underlying health status and health spending of the enrollees in an insurance plan when looking at their he...
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['glossary']
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['glossary']
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[]
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Rider (exclusionary rider)
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Enmienda (enmienda excluyente)
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/glossary/rider-exclusionary-rider/
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Una cláusula adicional es una enmienda a una póliza de seguro. Algunas cláusulas adicionales agregan cobertura (por ejemplo, si compra una cláusula adicional...
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A rider is an amendment to an insurance policy. Some riders add coverage (for example, if you buy a maternity rider to add coverage for pregnancy to your pol...
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['glossary']
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['glossary']
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[]
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Rescission
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Rescisión
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/glossary/rescission/
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Cancelación retroactiva de una póliza de seguro médico. En ciertas ocasiones, las compañías de seguros pueden cancelar retroactivamente la totalidad de su pó...
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The retroactive cancellation of a health insurance policy. Insurance companies will sometimes retroactively cancel your entire policy if you made a mistake o...
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['glossary']
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['glossary']
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[]
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Reinsurance
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Reaseguro
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/glossary/reinsurance/
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Sistema de reembolso que protege a las compañías de seguros de reclamaciones muy altas. En general, involucra a un tercero que paga parte de las reclamacione...
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A reimbursement system that protects insurers from very high claims. It usually involves a third party paying part of an insurance company’s claims once they...
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['glossary']
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['glossary']
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[]
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Rehabilitative/Rehabilitation Services
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Servicios de rehabilitación
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/glossary/rehabilitative-rehabilitation-services/
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Servicios de cuidado médico que ayudan a una persona a mantener, recobrar, o mejorar habilidades y funciones de la vida diaria que se han perdido o son defic...
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Health care services that help you keep, get back, or improve skills and functioning for daily living that have been lost or impaired because you were sick, ...
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['glossary']
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['glossary']
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[]
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Reconstructive Surgery
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Cirugía reconstructiva
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/glossary/reconstructive-surgery/
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Cirugía y tratamiento de seguimiento necesarios para corregir o mejorar una parte del cuerpo debido a defectos de nacimiento, accidentes, lesiones, o condici...
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Surgery and follow-up treatment needed to correct or improve a part of the body because of birth defects, accidents, injuries or medical conditions.
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['glossary']
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['glossary']
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[]
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Rate Review
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Revisión de tasas
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/glossary/rate-review/
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Proceso que permite a los departamentos estatales de seguros revisar los aumentos en las tarifas antes de que las compañías de seguros se los apliquen a uste...
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A process that allows state insurance departments to review rate increases before insurance companies can apply them to you.Related contentLook up your ...
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['glossary']
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['glossary']
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[]
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Qualified Health Plan
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Plan de salud autorizado (QHP en inglés)
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/glossary/qualified-health-plan/
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Un plan de seguro médico que está certificado por el Mercado de seguros, ofrece beneficios de salud esenciales, cumple los límites establecidos en cuanto a c...
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An insurance plan that’s certified by the Health Insurance Marketplace®, provides essential health benefits, follows established limits on cost-sharing (like...
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['glossary']
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['glossary']
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[]
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Public Health
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Salud pública
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/glossary/public-health/
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Área que tiene como objetivo mejorar la vida y la salud de las comunidades a través de la prevención y el tratamiento de enfermedades, y la promoción de comp...
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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 such...
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['glossary']
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['glossary']
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[]
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Primary Care
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Cuidado primario
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/glossary/primary-care/
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Servicios de salud que abarcan la prevención, el bienestar y el tratamiento de enfermedades comunes. Los proveedores de servicios de salud primarios incluye...
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Health services that cover a range of prevention, wellness, and treatment for common illnesses. Primary care providers include doctors, nurses, nurse practit...
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['glossary']
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['glossary']
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[]
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Primary Care Provider
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Proveedor de cuidados primarios
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/glossary/primary-care-provider/
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Un médico o doctor en medicina (M.D. en inglés), o doctor en osteopatía (D.O. en inglés), enfermera practicante, enfermera clínica especializada, o asistente...
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A physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine), nurse practitioner, clinical nurse specialist or physician assistant, as allowe...
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['glossary']
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['glossary']
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[]
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Primary Care Physician
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Médico de cuidados primarios/Médico de cabecera
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/glossary/primary-care-physician/
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Un médico o doctor en medicina (M.D. en inglés), o doctor en osteopatía (D.O. en inglés) que facilita o coordina directamente un conjunto de servicios médico...
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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 a patie...
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['glossary']
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['glossary']
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[]
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Preventive Services
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Servicios de prevención
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/glossary/preventive-services/
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Servicios de salud de rutina que incluyen exámenes, chequeos, y consejos al paciente, para prevenir enfermedades, condiciones, u otros problemas de salud.C...
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Routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems.Related contentP...
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['glossary']
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['glossary']
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[]
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Prevention
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Prevención
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/glossary/prevention-glossary/
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Una actividad para prevenir una enfermedad, como controles de rutina, inmunizaciones, asesoría y evaluaciones.
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Activities to prevent illness such as routine check-ups, immunizations, patient counseling, and screenings.
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['glossary']
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['glossary']
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[]
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Prescription Drugs
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Medicamentos recetados
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/glossary/prescription-drugs/
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Medicinas y medicamentos que por ley, requieren una receta médica.
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Drugs and medications that, by law, require a prescription.
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['glossary']
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['glossary']
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[]
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Prescription Drug Coverage
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Cobertura de medicamentos recetados
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/glossary/prescription-drug-coverage/
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Seguro o plan médico que ayuda a pagar por las medicinas y medicamentos recetados. Todos los planes del Mercado cubren medicamentos recetados.Contenido rel...
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Health insurance or plan that helps pay for prescription drugs and medications. All Marketplace plans cover prescription drugs.Related contentGetting pr...
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['glossary']
|
['glossary']
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[]
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Premium
|
Prima
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/glossary/premium/
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La cantidad que paga por su seguro médico cada mes. Además de su prima, por lo general tiene que pagar otros costos para su atención médica, incluyendo un de...
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The amount you pay for your health insurance every month. In addition to your premium, you usually have to pay other costs for your health care, including a ...
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['glossary']
|
['glossary']
|
[]
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Preferred Provider
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Proveedor preferido
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/glossary/preferred-provider/
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Un proveedor que tiene un contrato con su seguro o plan médico para facilitarle servicios con un descuento. Lea su póliza para averiguar si usted puede visit...
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A provider who has a contract with your health insurer or plan to provide services to you at a discount. Check your policy to see if you can see all preferre...
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['glossary']
|
['glossary']
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[]
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Preferred Provider Organization (PPO)
|
Organización de Proveedores Preferidos (PPO en inglés)
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/glossary/preferred-provider-organization-ppo/
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Un tipo de plan de salud que contrata proveedores médicos, tales como hospitales y médicos, para crear una red de proveedores participantes. Usted paga menos...
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[]
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[]
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[]
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[]
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[]
|
A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if y...
|
['glossary']
|
['glossary']
|
[]
|
Preauthorization
|
Preautorización
|
/glossary/preauthorization/
|
Una decisión de su seguro o plan de que un servicio, tratamiento, receta o equipo médico es necesario por razones médicas. A veces se le conoce como autoriza...
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[]
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[]
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[]
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[]
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[]
|
A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. ...
|
['glossary']
|
['glossary']
|
[]
|
Pre-Existing Condition
|
Condición pre-existente
|
/glossary/pre-existing-condition/
|
Un problema de salud, como el asma, la diabetes o el cáncer, que tenía antes de la fecha en que comienza la nueva cobertura de salud. Las compañías de seguro...
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[]
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[]
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[]
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[]
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[]
|
A health problem, like asthma, diabetes, or cancer, you had before the date that new health coverage starts. Insurance companies can't refuse to cover treatm...
|
['glossary']
|
['glossary']
|
[]
|
Pre-Existing Condition (Job-based Coverage)
|
Condición preexistente (en la cobertura de empleador)
|
/glossary/pre-existing-condition-job-based-coverage/
|
Cualquier condición (física o mental) o incapacidad para la que se haya recomendado o se haya hecho, un diagnóstico, atención o tratamiento, en los seis mese...
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[]
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[]
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[]
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[]
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[]
|
Any condition (either physical or mental) including a disability for which medical advice, diagnosis, care, or treatment was recommended or received within t...
|
['glossary']
|
['glossary']
|
[]
|
Pre-existing Condition Insurance Plan (PCIP)
|
Plan para condiciones preexistentes (PCIP)
|
/glossary/pre-existing-condition-insurance-plan-pcip/
|
Un programa (que ya no existe) creado por la Ley del Cuidado de Salud a Bajo Precio para proporcionar una opción de cobertura médica si no estaba asegurado p...
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[]
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[]
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[]
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[]
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[]
|
A program (that no longer exists) created by the Affordable Care Act to provide a health coverage option if you were uninsured for at least 6 months, had a p...
|
['glossary']
|
['glossary']
|
[]
|
Pre-Existing Condition Exclusion Period (Job-based Coverage)
|
Período de exclusión por una condición de salud preexistente (en la cobertura de empleador)
|
/glossary/pre-existing-condition-exclusion-period-job-based-coverage/
|
El período durante el cual su plan no pagará por los servicios para tratar una condición de salud preexistente. En un plan grupal de empleador, este período ...
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[]
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[]
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[]
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[]
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[]
|
The time period during which a health plan won't pay for care relating to a pre-existing condition. Under a job-based plan, this cannot exceed 12 months for ...
|
['glossary']
|
['glossary']
|
[]
|
Pre-Existing Condition Exclusion Period (Individual Policy)
|
Período de exclusión por una condición de salud preexistente (póliza de seguro individual)
|
/glossary/pre-existing-condition-exclusion-period-individual-policy/
|
El período durante el cual su póliza no pagará por sus condiciones de salud preexistentes. En una póliza individual, la exclusión puede ser permanente (se le...
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[]
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[]
|
[]
|
[]
|
[]
|
The time period during which an individual policy won't pay for care relating to a pre-existing condition. Under an individual policy, conditions may be excl...
|
['glossary']
|
['glossary']
|
[]
|
Policy Year
|
Año de la póliza
|
/glossary/policy-year/
|
Un período de 12 meses de cobertura de beneficios bajo un plan de seguro médico individual. Este período de 12 meses puede no coincidir con el año calendario...
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[]
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[]
|
[]
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[]
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[]
|
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. To find out ...
|
['glossary']
|
['glossary']
|
[]
|
Point of Service (POS) Plans
|
Plan de punto de servicio (POS en inglés)
|
/glossary/point-of-service-plan-pos-plan/
|
Un tipo de plan en el cual usted paga menos si usa médicos, hospitales y otros proveedores de servicios de salud que pertenecen a la red del plan. Los planes...
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[]
|
[]
|
[]
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[]
|
[]
|
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. POS plans also require...
|
['glossary']
|
['glossary']
|
[]
|
Plan
|
Plan
|
/glossary/plan/
|
Un beneficio que le ofrece su empleador, sindicato, u otro grupo patrocinador para ayudar a pagar por sus servicios de cuidado médico.
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[]
|
[]
|
[]
|
[]
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[]
|
A benefit your employer, union or other group sponsor provides to you to pay for your health care services.
|
['glossary']
|
['glossary']
|
[]
|
Plan Year
|
Año del plan
|
/glossary/plan-year/
|
Período de 12 meses de cobertura de beneficios bajo un plan de salud de grupo. Este período de 12 meses puede no coincidir con el año calendario. Para averig...
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[]
|
[]
|
[]
|
[]
|
[]
|
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. To find out when your plan y...
|
['glossary']
|
['glossary']
|
[]
|
Physician Services
|
Servicios del médico
|
/glossary/physician-services/
|
Servicios de la salud que facilita un médico licenciado o doctor en medicina (M.D. en inglés), o doctor en osteopatía (D.O. en inglés).
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[]
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[]
|
[]
|
[]
|
[]
|
Health care services a licensed medical physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine) provides or coordinates.
|
['glossary']
|
['glossary']
|
[]
|
Payment Bundling
|
Combinación de pagos
|
/glossary/payment-bundling/
|
Una plataforma de pago donde diferentes proveedores de servicios de salud que lo tratan a usted por la misma condición(es) relacionadas, reciben una suma tot...
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[]
|
[]
|
[]
|
[]
|
[]
|
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 care ...
|
['glossary']
|
['glossary']
|
[]
|
Patient Protection and Affordable Care Act
|
Ley de protección al paciente y del Cuidado de Salud a Bajo Precio
|
/glossary/patient-protection-and-affordable-care-act/
|
La primera parte de la ley de reforma de salud integral fue promulgada el 23 de marzo de 2010.La ley fue modificada por el Cuidado de la Salud y la Ley de ...
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[]
|
[]
|
[]
|
[]
|
[]
|
The first part of the comprehensive health care reform law enacted on March 23, 2010.The law was amended by the Health Care and Education Reconciliation Ac...
|
['glossary']
|
['glossary']
|
[]
|
Patient-Centered Outcomes Research
|
Estudios de resultados basados en los pacientes
|
/glossary/patient-centered-outcomes-research/
|
Estudios que comparan diferentes intervenciones y tratamientos médicos para proporcionar evidencia sobre qué estrategias son más eficaces en las diferentes p...
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[]
|
[]
|
[]
|
[]
|
[]
|
Research that compares different medical treatments and interventions to provide evidence on which strategies are most effective in different populations and...
|
['glossary']
|
['glossary']
|
[]
|
Out-of-Pocket Costs
|
Gastos de su bolsillo
|
/glossary/out-of-pocket-costs/
|
Sus gastos de cuidado médico que no son reembolsados por el seguro. Los gastos de su bolsillo incluyen deducibles, coseguros y copagos de los servicios cubie...
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[]
|
[]
|
[]
|
[]
|
[]
|
Your expenses for medical care that aren't reimbursed by insurance. Out-of-pocket costs include deductibles, coinsurance, and copayments for covered services...
|
['glossary']
|
['glossary']
|
[]
|
Open Enrollment Period
|
Período de Inscripción Abierta
|
/glossary/open-enrollment-period/
|
El período anual en el otoño cuando las personas pueden inscribirse en un plan médico para el próximo año calendario. La Inscripción Abierta para 2022 ha fin...
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[]
|
[]
|
[]
|
[]
|
[]
|
The yearly period in the fall when people can enroll in a health insurance plan for the next calendar year. Open Enrollment for 2022 is over, but you may sti...
|
['glossary']
|
['glossary']
|
[]
|
Nondiscrimination
|
No discriminación
|
/glossary/nondiscrimination/
|
Un requisito que exige que las coberturas subsidiadas por los empleadores no discriminen en base al estado de salud. La cobertura de los planes subsidiados p...
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[]
|
[]
|
[]
|
[]
|
[]
|
A requirement that job-based coverage not discriminate based on health status. Coverage under job-based plans cannot be denied or restricted. You also can't ...
|
['glossary']
|
['glossary']
|
[]
|
Non-preferred provider
|
Proveedor no preferido
|
/glossary/non-preferred-provider/
|
Un proveedor que no tiene un contrato con su compañía o plan de seguro médico, a la hora de proveerle servicios. Usted tendrá que pagar más para visitar a un...
|
[]
|
[]
|
[]
|
[]
|
[]
|
A provider who doesn’t have a contract with your health insurer or plan to provide services to you. You’ll pay more to see a non-preferred provider. Check yo...
|
['glossary']
|
['glossary']
|
[]
|
New Plan
|
Nuevo plan
|
/glossary/new-plan/
|
Un plan de salud sin derechos adquiridos y por tanto, sujeto a las reformas de la Ley de atención médica.En el Mercado de seguro médico individual, un plan ...
|
[]
|
[]
|
[]
|
[]
|
[]
|
As used in connection with the Affordable Care Act: A health plan that is not a grandfathered health plan and therefore subject to all of the reforms in the ...
|
['glossary']
|
['glossary']
|
[]
|
Network
|
Red
|
/glossary/network/
|
Los centros, proveedores, y suplidores que ha contratado su seguro o plan médico para facilitar servicios médicos.
|
[]
|
[]
|
[]
|
[]
|
[]
|
The facilities, providers and suppliers your health insurer or plan has contracted with to provide health care services.
|
['glossary']
|
['glossary']
|
[]
|
Minimum Essential Coverage (MEC)
|
Cobertura esencial mínima (MEC en inglés)
|
/glossary/minimum-essential-coverage/
|
Cualquier seguro que cumpla con el requisito de la Ley de Cuidado de Salud Accesible para tener cobertura médica. Para evitar tener que pagar la multa por no...
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[]
|
[]
|
[]
|
[]
|
[]
|
Any insurance plan that meets the Affordable Care Act requirement for having health coverage. To avoid the penalty for not having insurance for plans 2018 an...
|
['glossary']
|
['glossary']
|
[]
|
Medicare
|
Medicare
|
/glossary/medicare/
|
El programa federal de seguro médico para personas de 65 años o más y para ciertas personas más jóvenes con incapacidades. También cubre a personas que padec...
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[]
|
[]
|
[]
|
[]
|
[]
|
A federal health insurance program for people 65 and older and certain younger people with disabilities. It also covers people with End-Stage Renal Disease (...
|
['glossary']
|
['glossary']
|
[]
|
Medicare Prescription Drug Donut Hole
|
Interrupción de cobertura de medicamentos recetados de Medicare (“Donut Hole”)
|
/glossary/medicare-prescription-drug-donut-hole/
|
La mayoría de los planes con cobertura de medicamentos recetados de Medicare (Parte D) tienen una interrupción en la cobertura (llamada "Donut Hole"). Esto s...
|
[]
|
[]
|
[]
|
[]
|
[]
|
Most plans with Medicare prescription drug coverage (Part D) have a coverage gap (called a "donut hole"). This means that after you and your drug plan have s...
|
['glossary']
|
['glossary']
|
[]
|
Medicare Part D
|
Medicare Parte D
|
/glossary/medicare-part-d/
|
Un programa que ayuda a pagar los medicamentos recetados de personas con Medicare que compraron un plan que incluye cobertura de medicamentos recetados de Me...
|
[]
|
[]
|
[]
|
[]
|
[]
|
A program that helps pay for prescription drugs for people with Medicare who join a plan that includes Medicare prescription drug coverage. There are two way...
|
['glossary']
|
['glossary']
|
[]
|
Medicare Hospital Insurance Tax
|
Impuesto por seguro de hospital de Medicare
|
/glossary/medicare-hospital-insurance-tax/
|
Un impuesto bajo la Ley de Contribución al Seguro Federal (FICA en inglés); impuesto federal sobre las nóminas pagado por empleados y empleadores para financ...
|
[]
|
[]
|
[]
|
[]
|
[]
|
A tax under the Federal Insurance Contributions Act (FICA) that is a United States payroll tax imposed by the federal government on both employees and employ...
|
['glossary']
|
['glossary']
|
[]
|
Medicare Advantage (Medicare Part C)
|
Medicare Advantage (Medicare Parte C)
|
/glossary/medicare-advantage-medicare-part-c/
|
Un tipo de plan de salud de Medicare ofrecido por una compañía privada que entra en contrato con Medicare para brindarle todos los beneficios de Medicare Par...
|
[]
|
[]
|
[]
|
[]
|
[]
|
A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Ad...
|
['glossary']
|
['glossary']
|
[]
|
Medically Necessary
|
Necesario por razones médicas
|
/glossary/medically-necessary/
|
Servicios o suministros médicos necesarios para diagnosticar o tratar un problema de salud, lesión, condición, enfermedad o sus síntomas, y que cumplen con l...
|
[]
|
[]
|
[]
|
[]
|
[]
|
Health care services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medic...
|
['glossary']
|
['glossary']
|
[]
|
Medical Underwriting
|
Aprobación usando la historia clínica
|
/glossary/medical-underwriting/
|
Un proceso utilizado por las compañías de seguro, cuando usted solicita cobertura médica, para determinar a través de su historia clínica (estado de salud), ...
|
[]
|
[]
|
[]
|
[]
|
[]
|
A process used by insurance companies to try to figure out your health status when you're applying for health insurance coverage to determine whether to offe...
|
['glossary']
|
['glossary']
|
[]
|
Medical Loss Ratio (MLR)
|
Tasa de pérdidas médicas (MLR en inglés)
|
/glossary/medical-loss-ratio-mlr/
|
Una medida financiera básica usada bajo la Ley de atención médica para instar a los planes de salud a ofrecer calidad a sus afiliados. Si un asegurador usa 8...
|
[]
|
[]
|
[]
|
[]
|
[]
|
A basic financial measurement used in the Affordable Care Act to encourage health plans to provide value to enrollees. If an insurer uses 80 cents out of eve...
|
['glossary']
|
['glossary']
|
[]
|
Medicaid
|
Medicaid
|
/glossary/medicaid/
|
Un programa de seguro médico que ofrece cobertura médica gratis o de bajo costo para algunas personas de bajos ingresos, para las familias y niños, mujeres e...
|
[]
|
[]
|
[]
|
[]
|
[]
|
Insurance program that provides free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people wi...
|
['glossary']
|
['glossary']
|
[]
|
Long-Term Care
|
Cuidado a largo plazo
|
/glossary/long-term-care/
|
Servicios que incluyen atención médica y no médica ofrecida a personas que no pueden hacer actividades diarias básicas tales como vestirse o bañarse. Los ser...
|
[]
|
[]
|
[]
|
[]
|
[]
|
Services that include medical and non-medical care provided to people who are unable to perform basic activities of daily living such as dressing or bathing....
|
['glossary']
|
['glossary']
|
[]
|
Lifetime Limit
|
Límite vitalicio
|
/glossary/life-time-limit/
|
Un límite a los beneficios totales de por vida que puede conseguir de su compañía de seguros. Una compañía de seguros puede imponer un límite total en dólare...
|
[]
|
[]
|
[]
|
[]
|
[]
|
A cap on the total lifetime benefits you may get from your insurance company. An insurance company may impose a total lifetime dollar limit on benefits (like...
|
['glossary']
|
['glossary']
|
[]
|
Job-based Health Plan
|
Plan médico de empleador
|
/glossary/job-based-health-plan/
|
Cobertura ofrecida a un empleado (y a menudo a su familia) por un empleador.
|
[]
|
[]
|
[]
|
[]
|
[]
|
Coverage that is offered to an employee (and often his or her family) by an employer.
|
['glossary']
|
['glossary']
|
[]
|
Insurance Co-Op
|
Cooperativa de seguros
|
/glossary/insurance-co-op/
|
Una entidad sin fines de lucro en la que las mismas personas que son dueños de la compañía, están aseguradas por ésta. Las cooperativas pueden ser formadas a...
|
[]
|
[]
|
[]
|
[]
|
[]
|
A non-profit entity in which the same people who own the company are insured by the company. Cooperatives can be formed at a national, state or local level, ...
|
['glossary']
|
['glossary']
|
[]
|
Individual Health Insurance Policy
|
Póliza de seguro médico individual
|
/glossary/individual-health-insurance-policy/
|
Pólizas diseñadas para las personas que no están afiliadas a ninguna cobertura subsidiada por un empleador. Las pólizas de seguro médico individual están reg...
|
[]
|
[]
|
[]
|
[]
|
[]
|
Policies for people that aren't connected to job-based coverage. Individual health insurance policies are regulated under state law.
|
['glossary']
|
['glossary']
|
[]
|
In-network Coinsurance
|
Coseguro dentro de la red
|
/glossary/in-network-coinsurance/
|
El porcentaje (por ejemplo, el 20%) que usted paga de la cantidad autorizada por servicios de cuidado médico cubiertos para los proveedores que pertenecen a ...
|
[]
|
[]
|
[]
|
[]
|
[]
|
The percent (for example, 20%) you pay of the allowed amount for covered health care services to providers who contract with your health insurance or plan. I...
|
['glossary']
|
['glossary']
|
[]
|
In-network Copayment
|
Copago dentro de la red
|
/glossary/in-network-co-payment/
|
Un cantidad fija (por ejemplo, $15) que usted paga por los servicios de cuidado médico cubiertos a los proveedores que pertenecen a su seguro o plan médico. ...
|
[]
|
[]
|
[]
|
[]
|
[]
|
A fixed amount (for example, $15) you pay for covered health care services to providers who contract with your health insurance or plan. In-network copayment...
|
['glossary']
|
['glossary']
|
[]
|
Household
|
Hogar
|
/glossary/household/
|
Generalmente, el Mercado considera que su hogar se compone de usted, su cónyuge (si está casado) y sus dependientes fiscales. Su elegibilidad para los ahorro...
|
[]
|
[]
|
[]
|
[]
|
[]
|
The Marketplace generally considers your household to be you, your spouse if you’re married, and your tax dependents. Your eligibility for savings is general...
|
['glossary']
|
['glossary']
|
[]
|
Hospitalization
|
Hospitalización
|
/glossary/hospitalization/
|
Cuidados de hospital que requieren ser internado y usualmente requieren pasar una noche hospitalizado. La hospitalización por una noche únicamente para obser...
|
[]
|
[]
|
[]
|
[]
|
[]
|
Care in a hospital that requires admission as an inpatient and usually requires an overnight stay. An overnight stay for observation could be outpatient care.
|
['glossary']
|
['glossary']
|
[]
|
Hospital Readmissions
|
Readmisiones de hospitales
|
/glossary/hospital-readmissions/
|
Una situación en la que usted fue dado de alta del hospital y termina regresando para recibir la misma asistencia u otra relacionada en un plazo de 30, 60 o ...
|
[]
|
[]
|
[]
|
[]
|
[]
|
A situation where you were discharged from the hospital and wind up going back in for the same or related care within 30, 60 or 90 days. The number of hospit...
|
['glossary']
|
['glossary']
|
[]
|
Hospital Outpatient Care
|
Cuidado ambulatorio en el hospital
|
/glossary/hospital-outpatient-care/
|
Cuidado en un hospital que usualmente no requiere quedarse una noche.
|
[]
|
[]
|
[]
|
[]
|
[]
|
Care in a hospital that usually doesn’t require an overnight stay.
|
['glossary']
|
['glossary']
|
[]
|
Hospice Services
|
Servicios de hospicio
|
/glossary/hospice-services/
|
Servicio para de apoyo para mantener cómodas a las personas en las últimas etapas de una enfermedad terminal, así como a sus familias.
|
[]
|
[]
|
[]
|
[]
|
[]
|
Services to provide comfort and support for persons in the last stages of a terminal illness and their families.
|
['glossary']
|
['glossary']
|
[]
|
Home Health Care
|
Cuidados de salud en el hogar
|
/glossary/home-health-care/
|
Servicios de la salud que una persona recibe en su hogar.
|
[]
|
[]
|
[]
|
[]
|
[]
|
Health care services a person receives at home.
|
['glossary']
|
['glossary']
|
[]
|
Home and Community-Based Services (HCBS)
|
Servicios en el hogar y en la comunidad (HCBS en inglés)
|
/glossary/home-and-community-based-services-hcbs/
|
Servicios y asistencia ofrecidos en su hogar o en la comunidad, por la mayoría de los programas estatales de Medicaid, y que ayudan con las tareas diarias ta...
|
[]
|
[]
|
[]
|
[]
|
[]
|
Services and support provided by most state Medicaid programs in your home or community that gives help with such daily tasks as bathing or dressing. This ca...
|
['glossary']
|
['glossary']
|
[]
|
HIPAA Eligible Individual
|
Persona elegible para HIPAA
|
/glossary/hipaa-eligible-individual/
|
Situación en la que usted se encuentra luego de tener 18 meses seguidos de cobertura médica válida. Para ser elegible para HIPAA (Health Insurance Portabilit...
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Your status once you have had 18 months of continuous creditable health coverage. To be HIPAA (Health Insurance Portability and Accountability Act) eligible,...
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['glossary']
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['glossary']
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[]
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High-Risk Pool Plan (State)
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Plan de fondo común de alto riesgo (del estado)
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/glossary/high-risk-pool-plan-state/
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Similar al nuevo Plan de seguro para personas con condiciones preexistentes en virtud de la nueva Ley, durante muchos años, muchos estados han ofrecido plane...
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Similar to the Pre-Existing Condition Insurance Plan under the Affordable Care Act, for years many states have offered plans that provide coverage if you hav...
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['glossary']
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['glossary']
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High Deductible Health Plan (HDHP)
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Planes de Salud con Deducibles Altos (HDHP en inglés)
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/glossary/high-deductible-health-plan/
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Un plan con un deducible más alto que un plan de seguro tradicional. Por lo general, la prima mensual es más baja, pero tendrá que pagar más por la atención ...
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A plan with a higher deductible than a traditional insurance plan. The monthly premium is usually lower, but you pay more health care costs yourself before t...
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['glossary']
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['glossary']
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High-Cost Excise Tax
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Impuesto sobre altos costos
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/glossary/high-cost-excise-tax/
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Bajo la Ley de atención médica a partir del 2018, es un impuesto para las compañías de seguros que ofrecen planes de alto costo. Este impuesto insta a la ree...
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Under the Affordable Care Act starting in 2018, a tax on insurance companies that provide high-cost plans. This tax encourages streamlining of health plans t...
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['glossary']
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['glossary']
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[]
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Health Status
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Estado de salud
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/glossary/health-status/
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Se refiere a sus condiciones médicas (salud física y mental), sus experiencias en cuanto a reclamaciones, obtención de cuidados de salud, historia clínica, i...
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Refers to your medical conditions (both physical and mental health), claims experience, receipt of health care, medical history, genetic information, evidenc...
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['glossary']
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['glossary']
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Health Savings Account (HSA)
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Cuenta de ahorros para gastos médicos (HSA en inglés)
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/glossary/health-savings-account-hsa/
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Un tipo de cuenta de ahorros que le permite ahorrar dinero en una base antes de impuestos para pagar los gastos médicos calificados. Al usar dólares no sujet...
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A type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses. By using untaxed dollars in a Health Saving...
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['glossary']
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['glossary']
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Health Reimbursement Arrangement (HRA)
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Acuerdo de Reembolso de Gastos Médicos (HRA en inglés)
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/glossary/health-reimbursement-account-hra/
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Los HRA son planes de salud grupales financiados por el empleador, de los cuales los empleados reciben reembolsos libres de impuestos para gastos médicos cal...
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Health Reimbursement Arrangements (HRAs) are employer-funded group health plans from which employees are reimbursed tax-free for qualified medical expenses u...
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['glossary']
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['glossary']
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Health Maintenance Organization (HMO)
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Organización para el Mantenimiento de la Salud (HMO en inglés)
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/glossary/health-maintenance-organization-hmo/
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Variante de un plan de seguro médico que por lo general limita la cobertura a la atención que brindan aquellos médicos que trabajan para las HMO o tienen con...
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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-netw...
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['glossary']
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['glossary']
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Health Insurance
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Seguro médico
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/glossary/health-insurance/
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Un contrato que requiere que su compañía de seguro médico pague parte de, o todos sus costos médicos a cambio del pago de una prima.
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A contract that requires your health insurer to pay some or all of your health care costs in exchange for a premium.
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['glossary']
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['glossary']
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Health Insurance Marketplace®
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Mercado de Seguros Médicos
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/glossary/health-insurance-marketplace-glossary/
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Un servicio que ayuda a las personas a comprar e inscribirse en un seguro médico. El gobierno federal administra el Mercado de Seguros Médicos, disponible en...
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A service that helps people shop for and enroll in health insurance. The federal government operates the Health Insurance Marketplace®, available at HealthCa...
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['glossary']
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['glossary']
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Health Care Workforce Incentive
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Incentivo para el personal de cuidados de salud
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/glossary/health-care-workforce-incentive/
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El uso de incentivos y contratación para alentar a las personas a optar por profesiones de la salud, tales como la cuidado primario e instar a los proveedore...
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The use of incentives and recruiting to encourage people to enter into health care professions like primary care and to encourage providers to practice in un...
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['glossary']
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['glossary']
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Habilitative/Habilitation Services
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Servicios de rehabilitación
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/glossary/habilitative-habilitation-services/
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Servicios de salud que ayudan a una persona a mantener, aprender o mejorar las habilidades y funcionamiento en su vida diaria. Algunos ejemplos incluyen la t...
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Health care services that help you keep, learn, or improve skills and functioning for daily living. Examples include therapy for a child who isn't walking or...
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