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Levanter > Seguro de salud > Flashcards

Seguro de salud Flashcards

1
Q

Solicitud

A

Application

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2
Q

Retroactivo

A

Backdated/ Retroactive

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3
Q

Medicamentos de marca

A

Brand medications

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4
Q

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

A

Care coordinator

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5
Q

Condición Crónica

A

Chronic condition

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6
Q

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

A

Co-insurance

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7
Q

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.)

A

Co-pay

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8
Q

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.)

A

Cost sharing plan

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9
Q

Fecha limite/plazo

I can´t miss the deadline again.

A

Deadline

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10
Q

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

A

Dental coverage

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11
Q

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

A

Durable medical equipment

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12
Q

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

A

Eligibility

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13
Q

Inscribirse/inscripción.

A

Enroll/enrollment

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14
Q

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

A

Explanation of benefits

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15
Q

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

A

Fill medications

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16
Q

Formulario

A

Form

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17
Q

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

A

Formulary medications

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18
Q

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.)

A

FSA- Flexible Spending Account

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19
Q

Cobertura de brecha

A

GAP coverage

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20
Q

Medicamentos Genericos

A

Generic medications

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21
Q

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.)

A

Health Care

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22
Q

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)

A

HIPAA LAW (Healthh insurance portability and accountability act)

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23
Q

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)

A

HMO (Health maintenance organization) plan

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24
Q

Asistente doméstica (

A

Home attendant

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25
Q

Asistente de salud a domicilio

A

Home health aid

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26
Q

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

A

HSA-Health savings account

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27
Q

Dentro de la red

A

In network

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28
Q

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.)

A

IRA- Individual retirement account

29
Q

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

A

Manegement

30
Q

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

A

Marketplace

31
Q

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.)

A

Maximum out-of-pocket expense

32
Q

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

A

Medical clearance (authorization)

33
Q

Proveedor medico.

A

Medical Provider

34
Q

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

A

Member ID number

35
Q

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

A

MRN-Medical Record number

36
Q

Medicamentos sin cobertura.

A

Non-Formulary medications

37
Q

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

38
Q

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

A

Nurse ambassador

39
Q

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

A

Nurse case manager

40
Q

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

A

Open enrollment Period

41
Q

De venta libre (medications)

A

OTC (Over the counter)

42
Q

Fuera de la red.

A

Out of network

43
Q

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

44
Q

Papeleo/ documentación/ papeles

A

Paperwork/ documents

45
Q

Proveedores participantes

A

Participating providers

46
Q

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

47
Q

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.)

A

PPO (Preferred Provider Organization) Plan

48
Q

Preautorización

A

Pre-authorization

49
Q

Condición Preexistente

A

Pre-existing condition

50
Q

Sobre prepagado

A

Prepaid envelope

51
Q

Drogas recetadas (Im running out of prescription drugs)

A

Prescription drugs

52
Q

Cotizar/Cotización

53
Q

Referir/ remitir

54
Q

Referido.

55
Q

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

56
Q

Restitución/ Rehabilitación.

A

Reinstatement

57
Q

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

A

Renew/ Renewal

58
Q

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.

59
Q

Número de control de procesador de recetas

60
Q

Agendar una cita

A

Schedule an appointment

61
Q

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)

A

Screen/ Screening

62
Q

Con poco tiempo de anticipación.

A

Short notice

63
Q

Minorista/ vendedor al detalle.

64
Q

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

A

Subject to deductible

65
Q

Finalizado/ Cancelado (Your contract is terminated)

A

Terminated

66
Q

Niveles

67
Q

Cuidados de urgencia

A

Urgent Care

68
Q

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

A

Walk-in clinic

Levanter (16 decks)

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