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Health Insurance Flashcards

1
Q

Application

A

Solicitud

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2
Q

Backdated/ Retroactive

A

Retroactivo

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3
Q

Brand medications

A

Medicamentos de marca

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4
Q

Care coordinator

A

Coordinador (a) de cuidados (s a trained health professional that helps to manage a patient’s care, for example, the elderly or disabled.)

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5
Q

Chronic condition

A

Condición Crónica

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6
Q

Co-insurance

A

Seguro co-participe (The percentage of costs of a covered health care service you pay (20%, for example) after you’ve paid your deductible.)

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7
Q

Co-pay

A

Co-pago ( copay is a fixed amount you pay for a health care service, usually when you receive the service. The amount can vary by the type of service.)

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8
Q

Cost sharing plan

A

Plan de gastos compartidos (You pay some of your health care costs and your health insurance company pays some of your health care costs. If you get a service or procedure that’s covered by a health or dental plan, you “share” the cost by paying a copayment, or a deductible and coinsurance.)

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9
Q

Deadline

A

Fecha limite/plazo

I can´t miss the deadline again.

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10
Q

Dental coverage

A

Cobertura dental. (Dental coverage makes more affordable dental care)

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11
Q

Durable medical equipment

A

Equipo médico duradero. (I wanto to buy durable medical equipment).

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12
Q

Eligibility

A

Elegibilidad. (They are going to analize my eligibility to apply to health insurance).

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13
Q

Enroll/enrollment

A

Inscribirse/inscripción.

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14
Q

Explanation of benefits

A

Explicación de beneficios. (The care coordinator is going to say me my explanation of benefits of my insurance).

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15
Q

Fill medications

A

Surtir/ abastecer medicamentos. (I wento to the farmacy to fill my medications).

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16
Q

Form

A

Formulario

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17
Q

Formulary medications

A

Medicamentos aprobados por el seguro (This insurance has a lot of formulary medications)

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18
Q

FSA- Flexible Spending Account

A

Cuenta de gastos flexibles. (A Flexible Spending Account (also known as a flexible spending arrangement) is a special account you put money into that you use to pay for certain out-of-pocket health care costs.)

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19
Q

GAP coverage

A

Cobertura de brecha

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20
Q

Generic medications

A

Medicamentos Genericos

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21
Q

Health Care

A

Cuidado de la salud (is the maintenance or improvement of health via the prevention, diagnosis, treatment, recovery, or cure of disease, illness, injury, and other physical and mental impairments in people.)

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22
Q

HIPAA LAW (Healthh insurance portability and accountability act)

A

Ley de portabilidad y responsabilidad de seguros médicos (gives you rights over your health information and sets rules and limits on who can look at and receive your health information)

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23
Q

HMO (Health maintenance organization) plan

A

Organización de mantenimiento de la salud. ( a health insurance plan that provides health services through a network of doctors for a monthly or annual fee)

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24
Q

Home attendant

A

Asistente doméstica (

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25
Q

Home health aid

A

Asistente de salud a domicilio

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26
Q

HSA-Health savings account

A

Cuenta de ahorros para gastos médicos. (Do you have a health savings account?)

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27
Q

In network

A

Dentro de la red

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28
Q

IRA- Individual retirement account

A

Cuenta individual de jubilación (is an account set up at a financial institution that allows an individual to save for retirement with tax-free growth or on a tax-deferred basis.)

29
Q

Manegement

A

Gerencia/ administración/ manejo (I work in the management department)

30
Q

Marketplace

A

Mercado de seguros/ “marketplace” (Un servicio que ayuda a las personas a comprar e inscribirse en un seguro médico. )

31
Q

Maximum out-of-pocket expense

A

Gasto máximo de su bolsillo (Cantidad máxima que tiene que pagar por los servicios cubiertos en un año del plan. Después de gastar esta cantidad en los deducibles, copagos y coseguros por cuidado y servicios dentro de la red, su plan médico paga el 100% de los costos de los beneficios cubiertos.)

32
Q

Medical clearance (authorization)

A

Autorización médica (You need medical clearence to have the surgery).

33
Q

Medical Provider

A

Proveedor medico.

34
Q

Member ID number

A

Numero de identificación de miembro. (I need to verify your member ID number)

35
Q

MRN-Medical Record number

A

Número de expediente médico. (In the medical record number is the complete information of the patient.)

36
Q

Non-Formulary medications

A

Medicamentos sin cobertura.

37
Q

Notice

A

Aviso. (The insurance gave me the last notice to pay my deductible).

38
Q

Nurse ambassador

A

Enfermera embajadora ( Primary responsibilities are in the areas of promoting nursing as a career choice and educating the public about the nursing profession.)

39
Q

Nurse case manager

A

Enfermera administradora del caso (A nurse case manager is a registered nurse who coordinates overall care for patients in and out of medical facilities)

40
Q

Open enrollment Period

A

Periodo de inscripción abierto. (I cannot miss the open enrollment period.)

41
Q

OTC (Over the counter)

A

De venta libre (medications)

42
Q

Out of network

A

Fuera de la red.

43
Q

Overnight

A

De un día para otro (I had to visit de hospital overnight)

44
Q

Paperwork/ documents

A

Papeleo/ documentación/ papeles

45
Q

Participating providers

A

Proveedores participantes

46
Q

Photo ID

A

Identificación con fotografía. (They requested me to submit a photo ID)

47
Q

PPO (Preferred Provider Organization) Plan

A

Plan de organización de proveedor preferido. (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 you use providers that belong to the plan’s network.)

48
Q

Pre-authorization

A

Preautorización

49
Q

Pre-existing condition

A

Condición Preexistente

50
Q

Prepaid envelope

A

Sobre prepagado

51
Q

Prescription drugs

A

Drogas recetadas (Im running out of prescription drugs)

52
Q

Quote

A

Cotizar/Cotización

53
Q

Refer

A

Referir/ remitir

54
Q

Referral

55
Q

Refill

A

Reabastecer/ reabastecimiento. (I need to refill my prescription drugs)

56
Q

Reinstatement

A

Restitución/ Rehabilitación.

57
Q

Renew/ Renewal

A

Renovar/ Renovación. (Im going to renew my health insurance plan)

58
Q

Retailer

A

Minorista/ vendedor al detalle.

59
Q

Rx BIN

A

Numero de identificación de beneficios para recetas ( is used to identify how a prescription drug will be reimbursed and where a pharmacy can send a reimbursement claim to.)

60
Q

Rx PCN

A

Número de control de procesador de recetas

61
Q

Schedule an appointment

A

Agendar una cita

62
Q

Screen/ Screening

A

Evaluar/ Evaluación (the act of doing a test on a person or a person’s blood, urine, etc., to look for evidence of a disease, illegal drug, etc)

63
Q

Short notice

A

Con poco tiempo de anticipación.

64
Q

Subject to deductible

A

Sujeto a deductible. (All eligible expenses are subject to a $400 deductible.)

65
Q

Terminated

A

Finalizado/ Cancelado (Your contract is terminated)

66
Q

Tiers

67
Q

Urgent Care

A

Cuidados de urgencia

68
Q

Walk-in clinic

A

Clínica ambulatoria (s a medical facility that accepts patients on a walk-in basis and with no appointment required. )

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