Minnesota, New York, and Oregon have implemented a Basic Health Program – a coverage for people ineligible for Medicaid and with incomes up to 200% of FPL (250% in New York), and for legal immigrants who aren't eligible for Medicaid because of the five-year waiting period.| healthinsurance.org
A self-insured health plan (also known as a self-funded health plan) is coverage offered by an employer or association in which the employer (or association) takes on the risk involved with providing coverage, instead of purchasing coverage from an insurance company.| healthinsurance.org
Medicaid expansion extended eligibility to adults up to age 64 with incomes up to 138% of the federal poverty level. Washington, DC and 40 states have expanded Medicaid.| healthinsurance.org
Grandmothered plans are individual and small-group health plans that took effect after the ACA was signed into law in 2010, but before the exchanges opened for business in 2013. (In some states, grandmothered plans include plans that were issued as late as the end of 2013.)| healthinsurance.org
Grandfathered plans are health plans that were already in effect as of March 23, 2010, when the Affordable Care Act was signed into law. In the individual market, they are plans that already covered the policyholder as of that date, and in the employer-sponsored market, they are plans that the employer had already implemented as of that date, and has continuously offered ever since, with at least one covered employee at all times.| healthinsurance.org
Cost-sharing refers to the fact you – as a health insurance policy holder – and your health insurance company share in the cost of your covered health care services.| healthinsurance.org
The Affordable Care Act requires nearly all health plans to cover a wide range of free preventive health services including wide-ranging preventive care for everyone, preventive care for women and children, and vaccines for children and adults.| healthinsurance.org
An off-exchange plan is a health insurance policy that is purchased directly from an insurance company or through an agent or broker, outside of the official ACA-created health insurance exchange.| healthinsurance.org
There are two different meanings for the term benchmark plan – and both have to do with the Affordable Care Act: Benchmark plan is the term used to describe the second-lowest-cost Silver plan (SLCSP) available in the exchange/Marketplace, and it’s also the term for the plan that each state designates as the standard for essential health benefits (EHBs).| healthinsurance.org
Draft Recommendation| www.uspreventiveservicestaskforce.org
