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['glossary']
['glossary']
[]
Canceled Debts
Deudas canceladas
/glossary/cancelled-debts/
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 ...
['glossary']
['glossary']
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Bronze Health Plan
Plan médico de categoría Bronce
/glossary/bronze-health-plan/
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...
['glossary']
['glossary']
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Broker
Corredor (de seguros)
/glossary/broker/
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...
['glossary']
['glossary']
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Brand Name (Drugs)
Medicamentos de marca
/glossary/brand-name-drugs/
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...
['glossary']
['glossary']
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Authorized Representative
Representante autorizado
/glossary/authorized-representative/
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...
['glossary']
['glossary']
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Attest/Attestation
Atestiguar/Certificación
/glossary/attest-attestation/
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...
['glossary']
['glossary']
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Annual Deductible Combined
Deducible anual combinado
/glossary/annual-deductible-combined/
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...
['glossary']
['glossary']
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Alimony
Pensión alimenticia
/glossary/alimony/
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,...
['glossary']
['glossary']
[]
Agent and Broker (Health Insurance)
Agente y Corredor (Seguro Médico)
/glossary/agent/
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...
['glossary']
['glossary']
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Advance Premium Tax Credit (APTC)
Crédito fiscal anticipado para las primas
/glossary/advanced-premium-tax-credit/
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...
['glossary']
['glossary']
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Accreditation
Acreditación
/glossary/accreditation/
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...
['glossary']
['glossary']
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Wellness Programs
Programas de bienestar
/glossary/wellness-programs/
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 ...
['glossary']
['glossary']
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Well-baby and Well-child Visits
Consultas de prevención para bebés y niños
/glossary/well-baby-and-well-child-visits/
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...
['glossary']
['glossary']
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Waiting Period (Job-based coverage)
Periodo de espera (cobertura a través de un empleador)
/glossary/waiting-period-job-based-coverage/
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.
['glossary']
['glossary']
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Value-Based Purchasing (VBP)
Compra basada en la calidad (VBP en inglés)
/glossary/value-based-purchasing-vbp/
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...
['glossary']
['glossary']
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Urgent Care
Cuidados de urgencia
/glossary/urgent-care/
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.
['glossary']
['glossary']
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Uncompensated Care
Cuidados no compensados
/glossary/uncompensated-care/
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...
['glossary']
['glossary']
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UCR (Usual, Customary, and Reasonable)
Usual, acostumbrado, y razonable (UCR en inglés)
/glossary/ucr-usual-customary-and-reasonable/
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...
['glossary']
['glossary']
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State Continuation Coverage
Continuidad de la cobertura por el estado
/glossary/state-continuation-coverage/
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...
['glossary']
['glossary']
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Specialist
Especialista
/glossary/specialist/
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...
['glossary']
['glossary']
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Special Health Care Need
Necesidades de cuidado médico especial
/glossary/special-health-care-need/
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...
['glossary']
['glossary']
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Special Enrollment Period (SEP)
Período especial de inscripción (SEP)
/glossary/special-enrollment-period/
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...
['glossary']
['glossary']
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Skilled Nursing Facility Care
Cuidados en centros de enfermería especializada
/glossary/skilled-nursing-facility-care/
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...
['glossary']
['glossary']
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Skilled Nursing Care
Cuidados de enfermería especializada
/glossary/skilled-nursing-care/
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...
['glossary']
['glossary']
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Self-Insured Plan
Plan de seguro propio
/glossary/self-insured-plan/
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...
['glossary']
['glossary']
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Risk Adjustment
Ajuste de riesgos
/glossary/risk-adjustment/
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...
['glossary']
['glossary']
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Rider (exclusionary rider)
Enmienda (enmienda excluyente)
/glossary/rider-exclusionary-rider/
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...
['glossary']
['glossary']
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Rescission
Rescisión
/glossary/rescission/
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...
['glossary']
['glossary']
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Reinsurance
Reaseguro
/glossary/reinsurance/
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...
['glossary']
['glossary']
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Rehabilitative/Rehabilitation Services
Servicios de rehabilitación
/glossary/rehabilitative-rehabilitation-services/
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, ...
['glossary']
['glossary']
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Reconstructive Surgery
Cirugía reconstructiva
/glossary/reconstructive-surgery/
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.
['glossary']
['glossary']
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Rate Review
Revisión de tasas
/glossary/rate-review/
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 ...
['glossary']
['glossary']
[]
Qualified Health Plan
Plan de salud autorizado (QHP en inglés)
/glossary/qualified-health-plan/
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...
['glossary']
['glossary']
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Public Health
Salud pública
/glossary/public-health/
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...
['glossary']
['glossary']
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Primary Care
Cuidado primario
/glossary/primary-care/
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...
['glossary']
['glossary']
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Primary Care Provider
Proveedor de cuidados primarios
/glossary/primary-care-provider/
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...
['glossary']
['glossary']
[]
Primary Care Physician
Médico de cuidados primarios/Médico de cabecera
/glossary/primary-care-physician/
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...
['glossary']
['glossary']
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Preventive Services
Servicios de prevención
/glossary/preventive-services/
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...
['glossary']
['glossary']
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Prevention
Prevención
/glossary/prevention-glossary/
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.
['glossary']
['glossary']
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Prescription Drugs
Medicamentos recetados
/glossary/prescription-drugs/
Medicinas y medicamentos que por ley, requieren una receta médica.
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Drugs and medications that, by law, require a prescription.
['glossary']
['glossary']
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Prescription Drug Coverage
Cobertura de medicamentos recetados
/glossary/prescription-drug-coverage/
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...
['glossary']
['glossary']
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Premium
Prima
/glossary/premium/
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 ...
['glossary']
['glossary']
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Preferred Provider
Proveedor preferido
/glossary/preferred-provider/
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...
['glossary']
['glossary']
[]
Preferred Provider Organization (PPO)
Organización de Proveedores Preferidos (PPO en inglés)
/glossary/preferred-provider-organization-ppo/
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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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']
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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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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']
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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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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']
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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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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']
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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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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']
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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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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']
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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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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']
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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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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']
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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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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']
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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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A benefit your employer, union or other group sponsor provides to you to pay for your health care services.
['glossary']
['glossary']
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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']
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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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Health care services a licensed medical physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine) provides or coordinates.
['glossary']
['glossary']
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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']
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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']
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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']
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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']
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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']
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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']
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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...
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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']
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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 ...
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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']
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Network
Red
/glossary/network/
Los centros, proveedores, y suplidores que ha contratado su seguro o plan médico para facilitar servicios médicos.
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The facilities, providers and suppliers your health insurer or plan has contracted with to provide health care services.
['glossary']
['glossary']
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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']
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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']
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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...
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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']
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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...
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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']
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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...
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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']
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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...
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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']
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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...
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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']
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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), ...
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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']
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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...
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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']
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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...
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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']
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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...
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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']
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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...
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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']
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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.
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Coverage that is offered to an employee (and often his or her family) by an employer.
['glossary']
['glossary']
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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...
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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']
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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...
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Policies for people that aren't connected to job-based coverage. Individual health insurance policies are regulated under state law.
['glossary']
['glossary']
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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 ...
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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']
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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. ...
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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']
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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...
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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']
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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...
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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']
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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 ...
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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']
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Hospital Outpatient Care
Cuidado ambulatorio en el hospital
/glossary/hospital-outpatient-care/
Cuidado en un hospital que usualmente no requiere quedarse una noche.
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Care in a hospital that usually doesn’t require an overnight stay.
['glossary']
['glossary']
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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.
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Services to provide comfort and support for persons in the last stages of a terminal illness and their families.
['glossary']
['glossary']
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Home Health Care
Cuidados de salud en el hogar
/glossary/home-health-care/
Servicios de la salud que una persona recibe en su hogar.
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Health care services a person receives at home.
['glossary']
['glossary']
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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...
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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']
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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,...
['glossary']
['glossary']
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High-Risk Pool Plan (State)
Plan de fondo común de alto riesgo (del estado)
/glossary/high-risk-pool-plan-state/
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...
['glossary']
['glossary']
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High Deductible Health Plan (HDHP)
Planes de Salud con Deducibles Altos (HDHP en inglés)
/glossary/high-deductible-health-plan/
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...
['glossary']
['glossary']
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High-Cost Excise Tax
Impuesto sobre altos costos
/glossary/high-cost-excise-tax/
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...
['glossary']
['glossary']
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Health Status
Estado de salud
/glossary/health-status/
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...
['glossary']
['glossary']
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Health Savings Account (HSA)
Cuenta de ahorros para gastos médicos (HSA en inglés)
/glossary/health-savings-account-hsa/
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...
['glossary']
['glossary']
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Health Reimbursement Arrangement (HRA)
Acuerdo de Reembolso de Gastos Médicos (HRA en inglés)
/glossary/health-reimbursement-account-hra/
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...
['glossary']
['glossary']
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Health Maintenance Organization (HMO)
Organización para el Mantenimiento de la Salud (HMO en inglés)
/glossary/health-maintenance-organization-hmo/
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...
['glossary']
['glossary']
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Health Insurance
Seguro médico
/glossary/health-insurance/
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.
['glossary']
['glossary']
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Health Insurance Marketplace®
Mercado de Seguros Médicos
/glossary/health-insurance-marketplace-glossary/
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...
['glossary']
['glossary']
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Health Care Workforce Incentive
Incentivo para el personal de cuidados de salud
/glossary/health-care-workforce-incentive/
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...
['glossary']
['glossary']
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Habilitative/Habilitation Services
Servicios de rehabilitación
/glossary/habilitative-habilitation-services/
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...