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Make informed decisions about your coverage and care. 

  • Agent - Agents are a licensed salesperson who represents one or more health insurance companies and presents their products to consumers. Agents are licensed by each state, and must complete continuing education in order to keep their licenses active. 

  • Assister - Assisters must meet training and conflict-of-interest standards. They fill in gaps in areas that need more enrollment assistance, or provide outreach and education about the ACA to individuals who have not traditionally had access to health insurance coverage.

  • Broker - Brokers assist people to enroll in plans both on and off the website. Brokers are licensed by the states in which they work, and are paid commissions by health insurance carriers.

  • Certified Application Counselor [CAC] - CACs help people understand and choose the right health plan, conduct outreach,  maintain experience in eligibility, enrollment, and all insurance affordability program specifications.

  • Claim - An alternative way of saying bill as in medical bill.

  • Co-Insurance - The percentage “%” of a bill you must pay after a deductible is met.

  • Co-Payment - A predetermined (flat) fee that an individual pays for health care services, in addition to what the insurance covers. Can cover some costs for prescriptions if plan has option built into it.

  • Counselor Designated Organization [CDO] - CDOs oversee certified application counselors (CACs) who are trained and able to help consumers seeking health coverage options through the Marketplace.

  • Deductible - The amount you pay out of pocket for specific medical services before your insurance kicks into gear.

  • HSA - A tax-deductible savings account that is used in conjunction with an HSA-qualified high-deductible health insurance plan.

  • HDHP - High Deductible Health Plans are the only plans that allow an enrollee to contribute to a Health Savings Account (HSA). High-deductible insurance is considered a type of Consumer-Driven Health Plan, so you may hear the term CDHP used in conjunction with these plans. HDHPs cover preventive care before the deductible but, under an HDHP no other services can be paid for by the health plan until the insured has met the deductible.

  • HMO - Health Maintenance Organizations policies cover procedures ONLY performed in a network of healthcare providers

  • Insurance Policy - A document/framework detailing the terms and conditions of your health insurance.

  • Navigator – Navigators assist individuals in enrollment with coverage through the health insurance exchange, and refer or assist with Medicaid enrollment.

  • Premium - The bill you pay each month for your health insurance.

  • Primary Care Provider - A doctor you regularly see for checkups, non-emergency illnesses and references to see specialists. 

  • PPO - Preferred Provider Organization policies cover different doctors at different rates depending on whether they are in network or not.

  • Out-of-Pocket Maximum - The absolute maximum you will pay annually for health services.

Get Covered Today!

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