Across
- 4. This pertains to treatment from doctors, clinics, health centers, hospitals, medical practices, and other providers with whom your plan has an agreement to provide care for its members. Usually, you will pay less out of your own pocket when you receive treatment from in-network providers.
- 6. the monthly dollar amount owed by the consumer to the health plan as a condition of their enrollment.
- 7. out-of-pocket the most you must pay for covered services in a plan year. After you spend this amount on deductibles, co-pays, and coinsurance, your health plan pays 100% of the costs of covered benefits.
- 9. level plan a plan with a high deductible and low premiums.
Down
- 1. plan generally have a lower premium than other qualified health plans but a higher out-of-pocket cost for deductibles, co-pays, and co-insurances.
- 2. The New York State Department of Health (DOH) has been collecting, analyzing, and publicly reporting health plan performance since 1994. Health plan performance is evaluated annually based on quality, utilization, and member satisfaction metrics collected for a variety of plan products including Commercial, Medicaid, Child Health Plus and Preferred Provider Organizations (PPO).
- 3. (sometimes called copayment/co-payment/copay) is a fixed amount or cost a consumer pays directly to a provider when they receive a specific service. This amount can vary depending on the service.
- 5. the amount a consumer owes before the health insurance begins to pay for covered services.
- 8. plans Medicaid health plans for adults aged 21 and over who may need certain mental or behavioral health or substance use services. Consumers may be eligible to join a HARP if their need for these types of services makes it difficult to reach personal goals, such as employment, returning to school or finding suitable housing.