Glossary of Terms

Affordable Care Act (ACA)

The health care reform law passed in March 2010. The law was passed in two parts: The Patient Protection and Affordable Care Act was signed into law on March 23, 2010, and was changed by the Health Care and Education Reconciliation Act on March 30, 2010. The final version of…

Alien Emergency Medical Program

Alien Emergency Medical is a program for people who are experiencing a qualifying medical emergency and who aren’t eligible for Medicaid due to citizenship status or Social Security number requirements. To qualify, a person must be: a parent with a dependent child an adult with a disability a blind adult…

Allowed Amount

The highest dollar amount your health insurance plan will pay for covered health care services. This may also be called “eligible expense,” “payment allowance” or “negotiated rate.” If your provider charges more than the allowed amount, you may have to pay the difference. Your provider can only charge more than…

Annual Deductible Combined

The total amount that family members on a plan must pay out-of-pocket for health care or prescription drugs before the health plan begins to pay. This usually refers to plans that are eligible for Health Savings Accounts (HSAs).

Annual Limit

A cap on the benefits your insurance company will pay in a calendar year while you’re enrolled in a particular health insurance plan. These caps are sometimes placed on particular services such as prescriptions or hospitalizations. Annual limits may be placed on the dollar amount of covered services or on…

Anticipated Eligibility

Using the current information in your Washington Healthplanfinder account, anticipated eligibility is the the coverage you likely qualify for during the next coverage year. This could be a Qualified Health Plan with any cost-sharing reductions and health insurance premium tax credits, or it could be coverage through Washington Apple Health (Medicaid).

Appeal

A request for your health insurer or plan to review a decision or a grievance.

Attest/Attestation

When you apply for health coverage through Washington Healthplanfinder, you’re required to agree (or “attest”) to the truth of the information provided by signing the application.

Authorized Representative (AREP)

Someone you choose to act on your behalf with Washington Healthplanfinder, such as a family member or other trusted person. An Authorized Representative may be any adult who is aware of your circumstances and can act on your behalf to apply for, or maintain your benefits, including your health insurance…