See Summary of Benefits and Coverage
Healthcare and health insurance definitions.
The geographic area in which a health insurance plan’s benefits are available. Some health insurance plans will not provide coverage outside of the plan’s service area.
Services or care from nurses, therapists, or technicians in your home or in a nursing home. See ACA Uniform Glossary
A facility, either freestanding or part of a hospital, that accepts patients in need of rehabilitation and/or medical care that is of a lesser intensity than that received in a hospital.
See skilled nursing facility.
A time outside of the open enrollment period during which you and your family have a right to sign up for health insurance if you experienced certain life events that involve a change in family status (for example, marriage, or birth of a child) or loss of other health coverage.
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 conditions. A non-physician specialist is a provider who has more training in a specific area of healthcare. See ACA Uniform Glossary
When healthcare costs of enrollees are the responsibility of an entity other than the insurer, such as workers’ compensation, automobile coverage, or a third party.
The person responsible for payment of premiums to the insurance company, or whose employment or other status, except for family dependency, makes them eligible for enrollment in a health plan.
A summary of the costs and coverage of a health plan. The SBC must be used by all insurance companies to make it easier for people to compare plans based on price, benefits, or other features.