{"id":65,"date":"2024-04-05T07:43:27","date_gmt":"2024-04-05T07:43:27","guid":{"rendered":"https:\/\/uninsuredunaware.org\/?page_id=65"},"modified":"2026-09-12T22:30:34","modified_gmt":"2026-09-12T22:30:34","slug":"the-definitions","status":"publish","type":"page","link":"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/","title":{"rendered":"Las definiciones"},"content":{"rendered":"<div class=\"wp-block-cover alignfull is-light\" style=\"border-bottom-width:8px;margin-top:0px;margin-bottom:0px;min-height:206px;aspect-ratio:unset;\"><img fetchpriority=\"high\" decoding=\"async\" width=\"1707\" height=\"2560\" class=\"wp-block-cover__image-background wp-image-51\" alt=\"\" src=\"https:\/\/uninsuredunaware.org\/wp-content\/uploads\/2024\/04\/pexels-codioful-formerly-gradienta-7130488-scaled.jpg\" style=\"object-position:50% 33%\" data-object-fit=\"cover\" data-object-position=\"50% 33%\" srcset=\"https:\/\/uninsuredunaware.org\/wp-content\/uploads\/2024\/04\/pexels-codioful-formerly-gradienta-7130488-scaled.jpg 1707w, https:\/\/uninsuredunaware.org\/wp-content\/uploads\/2024\/04\/pexels-codioful-formerly-gradienta-7130488-200x300.jpg 200w, https:\/\/uninsuredunaware.org\/wp-content\/uploads\/2024\/04\/pexels-codioful-formerly-gradienta-7130488-683x1024.jpg 683w, https:\/\/uninsuredunaware.org\/wp-content\/uploads\/2024\/04\/pexels-codioful-formerly-gradienta-7130488-768x1152.jpg 768w, https:\/\/uninsuredunaware.org\/wp-content\/uploads\/2024\/04\/pexels-codioful-formerly-gradienta-7130488-1024x1536.jpg 1024w, https:\/\/uninsuredunaware.org\/wp-content\/uploads\/2024\/04\/pexels-codioful-formerly-gradienta-7130488-1365x2048.jpg 1365w\" sizes=\"(max-width: 1707px) 100vw, 1707px\" \/><span aria-hidden=\"true\" class=\"wp-block-cover__background has-background-dim-40 has-background-dim\" style=\"background-color:#7291a3\"><\/span><div class=\"wp-block-cover__inner-container has-global-padding is-layout-constrained wp-container-core-cover-is-layout-4a2dae69 wp-block-cover-is-layout-constrained\">\n<h1 class=\"wp-block-heading has-text-align-center has-text-color has-link-color has-cormorant-font-family wp-elements-1\" style=\"color:#ffffff;font-size:clamp(38.253px, 2.391rem + ((1vw - 3.2px) * 3.721), 71px);font-style:normal;font-weight:400;text-transform:uppercase\"><strong>Las definiciones<\/strong><\/h1>\n<\/div><\/div>\n\n\n\n<section class=\"wp-block-group alignfull has-text-color has-global-padding is-layout-constrained wp-container-core-group-is-layout-f7e06370 wp-block-group-is-layout-constrained\" style=\"border-style:none;border-width:0px;color:#3e3e3e;margin-top:0px;padding-top:38px;padding-right:1rem;padding-bottom:5px;padding-left:1rem;font-size:clamp(0.875rem, 0.875rem + ((1vw - 0.2rem) * 0.464), 1.13rem);font-style:normal;font-weight:400;line-height:1.4\">\n<h5 class=\"wp-block-heading has-text-align-center has-text-color has-link-color has-prata-font-family wp-elements-2\" style=\"color:#030113;padding-bottom:20px;font-size:clamp(1.453rem, 1.453rem + ((1vw - 0.2rem) * 1.722), 2.4rem);font-style:normal;font-weight:400\">Need-To-Know Terminology<\/h5>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em>Extra details and tips are marked in italics<\/em><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Find What You&#039;re Looking For<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1' ><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#Premium\" >Premium<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#Deductible\" >Deductible<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#Copay\" >Copay<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#Coinsurance\" >Coinsurance<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#Out-of-pocket_MaximumLimit\" >Out-of-pocket Maximum\/Limit<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#Network\" >Network<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#Preauthorization_Prior_Authorization\" >Preauthorization\/ Prior Authorization<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#Explanation_of_Benefits_EOB\" >Explanation of Benefits (EOB)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#Claim\" >Claim<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#Medicaid\" >Medicaid<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#Medicare\" >Medicare<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#HMO_Health_Maintenance_Organization\" >HMO (Health Maintenance Organization)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#EPO_Exclusive_Provider_Organization\" >EPO (Exclusive Provider Organization)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#PPO_Preferred_Provider_Organization\" >PPO (Preferred Provider Organization)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#HDHP_High_Deductible_Health_Plan\" >HDHP (High Deductible Health Plan)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#HSA_Health_Savings_Account\" >HSA (Health Savings Account)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/#FSA_Flexible_Spending_Account\" >FSA (Flexible Spending Account)<\/a><\/li><\/ul><\/nav><\/div>\n\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-c96c03c8 wp-block-columns-is-layout-flex\" style=\"padding-top:20px\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-bottom:1rem\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-3\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"Premium\"><\/span>Premium<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-4 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">This is the amount of money you pay to your insurance company monthly to keep your health insurance policy active, regardless of whether you use medical services or not. It&#8217;s like a membership fee.<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"border-top-style:none;border-top-width:0px;border-right-color:var(--wp--preset--color--contrast);border-right-width:1px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--contrast);border-left-width:1px;padding-right:30px;padding-bottom:1rem;padding-left:30px\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-5\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"Deductible\"><\/span>Deductible<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-6 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">The deductible is the amount of money you have to pay out of your own pocket for medical services before your insurance starts to cover costs. Once you&#8217;ve paid your deductible, your insurance begins to pay its share.<br><br><em>Indicated on your insurance card and on your insurance portal.<\/em><\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-bottom:1rem\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-7\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"Copay\"><\/span>Copay<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-8 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">The fixed amount you pay for specified medical services, such as doctor visits and prescriptions. <br><br><em>Copays for common services are typically indicated on your insurance card<\/em>. <em>Other services found online on your insurance portal or by calling your insurance care team.<\/em><\/p>\n<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-dots\"\/>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-c2035051 wp-block-columns-is-layout-flex\" style=\"margin-top:4rem;margin-bottom:0\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-bottom:1rem\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-9\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"Coinsurance\"><\/span>Coinsurance<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-10 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">The percentage of costs for a covered healthcare service that you&#8217;re responsible for paying after you&#8217;ve met your deductible.<br><br><em>For example, if your coinsurance is 20%, you&#8217;ll pay 20% of the cost of a covered service, while your insurance pays the remaining 80%.<\/em><\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"border-top-style:none;border-top-width:0px;border-right-color:var(--wp--preset--color--contrast);border-right-width:1px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--contrast);border-left-width:1px;padding-right:30px;padding-bottom:1rem;padding-left:30px\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-11\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"Out-of-pocket_MaximumLimit\"><\/span>Out-of-pocket Maximum\/Limit<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-12 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">This is the most you&#8217;ll have to pay for covered services in a plan year.Once you reach  this limit, your insurance pays 100% of covered services for the rest of the year. It includes deductibles, coinsurance, and copayments, but not premiums.<br><br><em>Health facilities are not usually aware if you have reached your limit. If you are asked to p<\/em>a<em>y a copay when you know you have reached your max, let the facility know and they will not charge you. <\/em><br><br><em>Check if you&#8217;ve reached your max through your insurance portal<\/em><\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-bottom:1rem\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-13\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"Network\"><\/span>Network<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-14 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">Group of doctors, hospitals, and other healthcare providers that have agreed to work with your insurance company to provide care at reduced rates.<br><br>In-network means your insurance plan is accepted by the doctor and\/or facility. Out-of-network typically means your insurance will not cover anything since your plan is not accepted. <br><br><em>Always check with your insurance and the physician\/facility to make sure your plan is in-network for ANY medical service (ex. bloodwork, imaging, doctor visit, physical therapy)<\/em>.<\/p>\n<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-dots\"\/>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-c2035051 wp-block-columns-is-layout-flex\" style=\"margin-top:4rem;margin-bottom:0\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-bottom:1rem\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-15\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"Preauthorization_Prior_Authorization\"><\/span>Preauthorization\/ Prior Authorization<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-16 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">Sometimes, your insurance company requires preauthorization before you can receive certain medical services or medications. This means your doctor needs approval from your insurance company before proceeding with treatment to ensure it&#8217;s medically necessary. <br><br><em>Typically, this is handled by the physician. But you can always call your insurance to check if it is required or to check the progress on its review.<\/em><\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"border-top-style:none;border-top-width:0px;border-right-color:var(--wp--preset--color--contrast);border-right-width:1px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--contrast);border-left-width:1px;padding-right:30px;padding-bottom:1rem;padding-left:30px\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-17\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"Explanation_of_Benefits_EOB\"><\/span>Explanation of Benefits (EOB)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-18 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">This is a statement from your insurance company that explains how a medical claim was processed, including what was covered, what wasn&#8217;t covered, and any amount you may owe.<br><br><em>If you believe you were falsely charged by your physician or facility, this is the document you give to their billing department to show what you are accountable for. <\/em><\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-bottom:1rem\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-19\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"Claim\"><\/span>Claim<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-20 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">A claim is a formal request made by you or your healthcare provider to your health insurance company for payment of covered medical services. When you receive medical care, whether it&#8217;s a doctor&#8217;s visit, hospital stay, or prescription medication, the provider generates a bill for those services. This bill is then submitted to your insurance company as a claim.<br><br><em>If your insurance wasn&#8217;t charged for a service, you can file a claim on your own by calling your insurance. You can also appeal claims if you believe there was an error. <\/em><\/p>\n<\/div>\n<\/div>\n\n\n\n<div style=\"height:11px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<hr class=\"wp-block-separator alignwide has-alpha-channel-opacity\"\/>\n\n\n\n<h5 class=\"wp-block-heading has-text-align-center has-text-color has-link-color has-prata-font-family wp-elements-21\" style=\"color:#030113;padding-bottom:20px;font-size:clamp(1.453rem, 1.453rem + ((1vw - 0.2rem) * 1.722), 2.4rem);font-style:normal;font-weight:400\">Different Types of Insurance<\/h5>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em>Extra details and tips are marked in italics<\/em><\/p>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-c2035051 wp-block-columns-is-layout-flex\" style=\"margin-top:4rem;margin-bottom:0\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-bottom:1rem\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-22\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"Medicaid\"><\/span>Medicaid<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-23 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">A government-sponsored health insurance program that provides free coverage to low-income individuals and families who do not have access to healthcare otherwise. Eligibility and benefits vary by state, but U.S. citizenship is typically required.<br><br>Typically offers HMO plans, which have the least amount of physicians available in-network. Emergency visits are covered. <br><br><em>If you are eligible for Medicaid, you  are typically ineligible for any tax credits in Affordable Care Act-based plans.<\/em><\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"border-top-style:none;border-top-width:0px;border-right-color:var(--wp--preset--color--contrast);border-right-width:1px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--contrast);border-left-width:1px;padding-right:30px;padding-bottom:1rem;padding-left:30px\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-24\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"Medicare\"><\/span>Medicare<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-25 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">Federal program for people who are 65 or older, as well as certain younger individuals with disabilities or specific medical conditions.<br><br>Has different bundles: <br><br><strong>Original Medicare<\/strong> &#8211; includes Part A (hospital insurance) Part B (medical insurance).<\/p>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-26 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\"><em>Can go to any doctor<\/em> <em>that accepts Medicare. No referral.<\/em><br><em>Can buy Part D (prescription coverage) separately.<\/em><br><br><strong>Medicare Advantage<\/strong> (aka Part C) &#8211; these include Part A, B, and D.<br><br><em>Need to stick to in-network doctors. Need referral.<\/em><\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-bottom:1rem\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-27\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"HMO_Health_Maintenance_Organization\"><\/span>HMO (Health Maintenance Organization)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-28 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">Type of health insurance plan that typically requires members to select a primary care physician (PCP) and get referrals from their PCP to see specialists. <br><br><em>Lowest premium\/deductible costs<\/em><br><br><em>Have a very limited network of physicians: call your insurance to get a list<\/em> <em>of providers based on what treatment you need that accept your insurance. Then call the provider that you prefer and make sure they verify your insurance is approved<\/em> <em>since the list is not always the most updated. <\/em><\/p>\n<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-dots\"\/>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-c2035051 wp-block-columns-is-layout-flex\" style=\"margin-top:4rem;margin-bottom:0\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-bottom:1rem\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-29\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"EPO_Exclusive_Provider_Organization\"><\/span>EPO (Exclusive Provider Organization)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-30 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">Type of health insurance plan that is similar to HMO, but does not require members to select a primary care physician (PCP) or obtain referrals to see specialists. <br><br><em>Coverage is still limited to physicians in-network. Typically greater choice of physicians than HMO, but less than PPO.<\/em><\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"border-top-style:none;border-top-width:0px;border-right-color:var(--wp--preset--color--contrast);border-right-width:1px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--contrast);border-left-width:1px;padding-right:30px;padding-bottom:1rem;padding-left:30px\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-31\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"PPO_Preferred_Provider_Organization\"><\/span>PPO (Preferred Provider Organization)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-32 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">Type of health insurance plan that offers the most flexibility in choosing healthcare providers with more in-network options. Referrals are typically not required for specialist visits.<br><br>Members may have the option to see out-of-network providers at a higher cost with some coverage.<br><br><em>Higher choice of providers means higher premiums\/deductible plans compared to HMOs and EPOs.<\/em> <\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-bottom:1rem\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-33\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"HDHP_High_Deductible_Health_Plan\"><\/span>HDHP (High Deductible Health Plan)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-34 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">Type of health insurance plan with higher deductibles and lower premiums compared to traditional health plans. Typically require individuals to pay higher out-of-pocket costs for medical expenses before the insurance company starts to pay for covered services.<br><br>Paired with HSAs. <br><br><em>Gives consumers ability to only pay for when they need treatment and have a safety net in case of an emergency. Relatively healthy individuals who do not need much treatment would find this most optimal in needing to only pay a low premium. <\/em><\/p>\n<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-dots\"\/>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-c2035051 wp-block-columns-is-layout-flex\" style=\"margin-top:4rem;margin-bottom:0\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-bottom:1rem\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-35\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"HSA_Health_Savings_Account\"><\/span>HSA (Health Savings Account)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-36 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">Tax-advantaged savings account available to individuals enrolled in a HDHP.  Funds in the account can be withdrawed tax-free to pay for qualified medical expenses. <br><br>&#8211; <em>Contributions are pre-tax (money deducted from paycheck before taxes withheld). <\/em><br><br>&#8211; <em>Money in HSA can grow tax-free through forms of investments as long as funds stay in the account.<\/em><br><br>&#8211; <em>Unused funds roll over to next year unlike HSA<\/em>. <em>Does not expire.<\/em><\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"border-top-style:none;border-top-width:0px;border-right-color:var(--wp--preset--color--contrast);border-right-width:1px;border-bottom-style:none;border-bottom-width:0px;border-left-color:var(--wp--preset--color--contrast);border-left-width:1px;padding-right:30px;padding-bottom:1rem;padding-left:30px\">\n<h3 class=\"wp-block-heading has-text-align-left has-text-color has-link-color has-prata-font-family wp-elements-37\" style=\"color:#0300a8;font-size:clamp(1.092rem, 1.092rem + ((1vw - 0.2rem) * 1.105), 1.7rem);font-style:normal;font-weight:400\"><span class=\"ez-toc-section\" id=\"FSA_Flexible_Spending_Account\"><\/span>FSA (Flexible Spending Account)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-38 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">Employer-sponsored benefit that allows employees to set aside pre-tax dollars from their paycheck to pay for eligible medical expenses with tax-free withdrawals.<\/p>\n\n\n\n<p class=\"has-text-align-left has-pontano-sans-font-family has-text-color has-link-color wp-elements-39 wp-block-paragraph\" style=\"color:#3e3e3e;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);\">Unlike HSAs, FSAs are &#8220;use it or lose it,&#8221; so any funds not used by the end of the year are forfeited. (Some plans may offer a grace period or carryover option)<br><br><em>Unlike HSAs, if you leave your job or change employers, you lose access to your FSA funds. <\/em><\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-bottom:1rem\"><\/div>\n<\/div>\n\n\n\n<section class=\"wp-block-cover alignwide\" style=\"padding-top:1.6rem;padding-bottom:0.2rem;min-height:217px;aspect-ratio:unset;\"><img decoding=\"async\" width=\"258\" height=\"148\" class=\"wp-block-cover__image-background wp-image-81\" alt=\"\" src=\"https:\/\/uninsuredunaware.org\/wp-content\/uploads\/2024\/04\/download.jpeg\" data-object-fit=\"cover\"\/><span aria-hidden=\"true\" class=\"wp-block-cover__background has-background-dim-0 has-background-dim\" style=\"background-color:#090909\"><\/span><div class=\"wp-block-cover__inner-container has-global-padding is-layout-constrained wp-container-core-cover-is-layout-a284e307 wp-block-cover-is-layout-constrained\">\n<div class=\"wp-block-group alignfull has-text-color has-global-padding is-layout-constrained wp-container-core-group-is-layout-af600e2e wp-block-group-is-layout-constrained\" style=\"color:#252525;margin-top:0px;padding-top:0rem;padding-right:1rem;padding-bottom:0rem;padding-left:1rem;font-size:clamp(0.875rem, 0.875rem + ((1vw - 0.2rem) * 0.464), 1.13rem);font-style:normal;font-weight:400;line-height:1.4\">\n<div class=\"wp-block-group is-vertical is-content-justification-center is-layout-flex wp-container-core-group-is-layout-eedd5f1d wp-block-group-is-layout-flex\">\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-7cdfdd2f wp-block-group-is-layout-constrained\">\n<h2 class=\"wp-block-heading has-text-align-center has-text-color has-prata-regular-font-family\" style=\"color:#ffffff;margin-bottom:1.11rem;font-size:clamp(1.25rem, 1.25rem + ((1vw - 0.2rem) * 1.364), 2rem);font-style:normal;font-weight:500;line-height:1.2\">\u00a1Mantente informado sobre las \u00faltimas noticias!<\/h2>\n\n\n\n<p class=\"has-text-align-center has-text-color has-link-color has-prata-regular-font-family wp-elements-40 wp-block-paragraph\" style=\"color:#e8efff;margin-top:0rem;font-size:clamp(0.984rem, 0.984rem + ((1vw - 0.2rem) * 0.938), 1.5rem);font-style:normal;font-weight:400;line-height:1.2\">No seas inconsciente:<\/p>\n\n\n\n<p class=\"has-text-align-center has-text-color has-link-color wp-elements-41 wp-block-paragraph\" style=\"color:#ffffff\"><div class=\"tnp tnp-subscription\">\n<form method=\"post\" action=\"https:\/\/uninsuredunaware.org\/wp-admin\/admin-ajax.php?action=tnp&amp;na=s\">\n<input type=\"hidden\" name=\"nlang\" value=\"\">\n<div class=\"tnp-field tnp-field-email\"><label for=\"tnp-1\">Correo electr\u00f3nico<\/label>\n<input class=\"tnp-email\" type=\"email\" name=\"ne\" id=\"tnp-1\" value=\"\" placeholder=\"Tu mejor correo electr\u00f3nico\" required><\/div>\n<div class=\"tnp-field tnp-field-button\" style=\"text-align: left\"><input class=\"tnp-submit\" type=\"submit\" value=\"\u00a1\u00danete!\" style=\"\">\n<\/div>\n<\/form>\n<\/div>\n<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div><\/section>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>Need-To-Know Terminology Extra details and tips are marked in italics Premium This is the amount of money you pay to your insurance company monthly to keep your health insurance policy active, regardless of whether you use medical services or not. It&#8217;s like a membership fee. Deductible The deductible is the amount of money you have [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1013,"parent":13,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-65","page","type-page","status-publish","has-post-thumbnail","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The Definitions ~ Uninsured &amp; Unaware<\/title>\n<meta name=\"description\" content=\"Become aware of need-to-know definitions and terminology related to health insurance so you can advocate for yourself and loved ones!\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/uninsuredunaware.org\/es\/learn\/the-definitions\/\" \/>\n<meta property=\"og:locale\" content=\"es_MX\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Definitions ~ Uninsured &amp; 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