Health Insurance Terms
POS - A Point-of-Service plan offers access to doctors and hospitals in a network. For the highest level of benefits, a primary care physician can refer in-network specialists.
PPO - PPO stands for preferred provider organization. A PPO is a type of health plan that allows members to see providers in and out of the network. You pay lower costs when you see network providers. But you can go outside the network and pay more for your services.
precertification - This may also be called preapproval, pre-authorization, or prior authorization. Basically, you may need additional approval from your health plan before you receive certain tests, procedures, or medications.
precertification - This may also be called preapproval or pre-authorization.It means you may need extra approval from your health plan before you receive certain tests, procedures, or medications. It’s a way to make sure the services you’re getting are safe and effective.
preexisting condition - Any condition, illness, or injury for which medical advice or treatment was recommended or received before a person obtains health insurance. Examples include diabetes, heart disease, and cancer. As part of the ACA, no one can be denied health insurance due to a preexisting condition.
premium - Sometimes called a monthly rate, it’s the set dollar amount you pay each month for health insurance.
preventive care - Services that are intended to help you stay healthy and may also detect some diseases in the early stages. Examples include flu shots, mammograms, colonoscopies, and cholesterol tests.
primary care physician - Often abbreviated to PCP, this is just another term for your family doctor, or the doctor you see for most of your health care needs. A primary care physician focuses on preventive care and the treatment of routine injuries and illnesses, and may recommend a specialist as needed.
provider - Health care professionals and facilities, such as doctors and hospitals.