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['glossary']
['glossary']
[]
Affordability Exemption
Exención de accesibilidad
/glossary/affordability-exemption/
Una exención que se necesita al solicitar cobertura catastrófica para personas de 30 años o más cuya cobertura no es accesible. Las exenciones de accesibilid...
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An exemption that’s needed when applying for Catastrophic coverage for people 30 years or older whose coverage is unaffordable. Affordability exemptions are ...
['glossary']
['glossary']
[]
Individual Coverage Health Reimbursement Arrangement
Acuerdo de reembolso de gastos médicos de cobertura individual
/glossary/individual-coverage-hra/
Un tipo de Acuerdo de Reembolso de Gastos Médicos (HRA en inglés) que reembolsa los gastos médicos, como las primas mensuales, y requiere que los empleados y...
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A type of Health Reimbursement Arrangement that reimburses medical expenses, like monthly premiums, and requires eligible employees and dependents to have in...
['glossary']
['glossary']
[]
Cafeteria Plan
Plan de gastos flexibles
/glossary/cafeteria-plan/
Un plan de gastos flexibles es un plan escrito separado mantenido por un empleador para empleados que cumple con los requisitos y regulaciones específicos de...
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A cafeteria plan is a separate written plan maintained by an employer for employees that meets the specific requirements and regulations of Section 125 of th...
['glossary']
['glossary']
[]
Urban Indian programs
Programas urbanos para Indios
/glossary/urban-indian-programs/
Programas de salud disponibles para Indios Americanos y nativos de Alaska que viven en áreas urbanas.Los programas de salud urbana atienden:Miembros o d...
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Health programs available to American Indians and Alaska Natives living in urban areas.Urban health programs serve:Members or descendants of federally r...
['glossary']
['glossary']
[]
QSEHRA
QSEHRA
/glossary/qsehra/
Los pequeños empleadores que no ofrecen cobertura médica grupal a sus empleados pueden ayudar a los empleados a pagar los gastos médicos a través de un Acuer...
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Small employers who don't offer group health coverage to their employees can help employees pay for medical expenses through a Qualified Small Employer Healt...
['glossary']
['glossary']
[]
Abortion services
Servicios de aborto
/glossary/abortion-services/
La ley federal prohíbe que los fondos federales, incluidos los créditos fiscales para las primas del Mercado, se utilicen para servicios de aborto, excepto e...
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Federal law prohibits federal funds, including Marketplace premium tax credits, from being used for abortion services except in the limited cases of rape, in...
['glossary']
['glossary']
[]
Small Business Health Options Program (SHOP)
Mercado SHOP (Programa de Opciones de Salud para Pequeños Negocios)
/glossary/shop-small-business-health-options-program/
Un intercambio de seguro médico que ayuda a los propietarios de pequeños negocios a proporcionar seguro médico y dental a sus empleados. Algunos empleadores ...
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The Small Business Health Options Program (SHOP) helps small business owners provide medical and/or dental insurance to their employees. Some smaller employe...
['glossary']
['glossary']
[]
Tax filing requirement (for dependents)
Requisito de presentación de impuestos (para dependientes)
/glossary/tax-filing-requirement-dependents/
La cantidad mínima de ingreso que requiere que un dependiente presente una declaración federal de impuestos. Los requisitos para presentar impuestos 2021 par...
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The minimum income requiring a dependent to file a federal tax return. 2021 filing requirements for dependents under 65: Earned income of at least $12,550, o...
['glossary']
['glossary']
[]
Quality Ratings (or 'star' ratings)
Calificación de Calidad (o calificación de 'estrellas')
/glossary/quality-ratings/
La calificación de calidad del plan médico usado en el Mercado de Seguros Médicos, muestra 1 a 5 estrellas en las páginas de información del plan.Cada plan...
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Ratings of health plan quality used in the Health Insurance Marketplace®, shown as 1 to 5 stars on plan information pages.Each health plan has an “Overall”...
['glossary']
['glossary']
[]
Grace Period
Período de Gracia
/glossary/grace-period/
Un período corto — generalmente de 90 días — luego de que se haya vencido su pago mensual del seguro médico, puede pagarlo durante su período de gracia y evi...
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A short period — usually 90 days — after your monthly health insurance payment is due. If you haven't made your payment, you may do so during the grace perio...
['glossary']
['glossary']
[]
Adjusted Gross Income (AGI)
Ingreso Bruto Ajustado (AGI en inglés)
/glossary/adjusted-gross-income-agi/
Su ingreso total (o "bruto") para el año fiscal, menos ciertos ajustes que se le permita tomar. Los ajustes incluyen deducciones por contribuciones de IRA co...
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Your total (or “gross”) income for the tax year, minus certain adjustments you’re allowed to take. Adjustments include deductions for conventional IRA contri...
['glossary']
['glossary']
[]
Tax filing requirement
Requisito de presentación de impuestos
/glossary/tax-filing-requirement/
La cantidad mínima (o límite) de ingreso que requiere que usted presente una declaración federal de impuestos. Los requisitos de 2021 para presentar impuesto...
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The minimum amount (or threshold) of income requiring you to file a federal tax return. 2021 filing requirements for most taxpayers: Gross income of at least...
['glossary']
['glossary']
[]
Qualifying Health Coverage
Cobertura Calificada
/glossary/qualifying-health-coverage/
Cualquier seguro médico que cumpla los requisitos de cobertura de la Ley de Cuidado de Salud a bajo precio. Ya no aplica la multa por no tener seguro médico....
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Any health insurance that meets the Affordable Care Act requirement for coverage. The fee for not having health insurance no longer applies. This means you n...
['glossary']
['glossary']
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Inconsistency (Data Matching Issue)
Inconsistencia (problema de datos)
/glossary/inconsistency/
Una diferencia entre cierta información que puso en su solicitud del Mercado y la información que tenemos de otras fuentes de datos de confianza.Si esto su...
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A difference between some information you put on your Marketplace application and information we have from other trusted data sources.If this happens, the ...
['glossary']
['glossary']
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Data Matching Issue (Inconsistency)
Problema con comparación de datos (o inconsistencia)
/glossary/data-matching-issue/
Una diferencia entre cierta información que puso en su solicitud del Mercado y la información que tenemos de otras fuentes de datos de confianza.Si esto su...
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A difference between some information you put on your Marketplace health insurance application and information we have from other trusted data sources.If t...
['glossary']
['glossary']
[]
Same-Sex Marriage
Matrimonio del Mismo Sexo
/glossary/same-sex-marriage/
Matrimonio legal entre cónyuges del mismo sexo. El matrimonio entre personas del mismo sexo es legal y está reconocido en todos los estados de Estados Unidos...
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Lawful marriage between spouses of the same sex. Same-sex marriage is legal and recognized in every U.S. state and the District of Columbia.As long as a sa...
['glossary']
['glossary']
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Transgender People
Personas Transgénero
/glossary/transgender-people/
El sexo asignado al nacer de una persona transgénero no coincide con su identidad, expresión o comportamiento de género.Los transgéneros deben considerar de...
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A transgender person’s assigned sex at birth doesn’t match their gender identity, expression, or behavior.Transgender people have important details to cons...
['glossary']
['glossary']
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Exemption
Exenciones
/glossary/exemption/
Si tiene 30 años o más y quiere cobertura catastrófica, debe calificar para una exención por "dificultades" o "accesibilidad".Para los planes de 2018 o ant...
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If you’re 30 and older and want Catastrophic coverage, you must qualify for a "hardship" or "affordability" exemption.For plan years 2018 and earlier, othe...
['glossary']
['glossary']
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Stand-alone Dental Plan
Plan dental independiente
/glossary/stand-alone-dental-plan/
Un tipo de plan dental ofrecido a través del Mercado que no está incluido como parte de un plan médico. Es posible que desee esto si la cobertura que elige n...
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A type of dental plan offered through the Marketplace that’s not included as part of a health plan. You may want this if the health coverage you choose doesn...
['glossary']
['glossary']
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Spousal Abandonment
Abandono del cónyuge
/glossary/spousal-abandonment/
Cuando una persona no puede localizar a su cónyuge después de hacer un intento razonable para encontrarlo. También conocida como deserción. Si es víctima de ...
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When an individual can’t locate their spouse after making a reasonable attempt to find them. Also known as desertion. If you’re a victim of spousal abandonme...
['glossary']
['glossary']
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Exemption Certificate Number (ECN)
Número de certificado de exención (ECN en inglés)
/glossary/exemption-certificate-number-ecn/
El número que el Mercado de seguros le provee cuando califica para una exención de cobertura médica. Cuando llena una solicitud de exención, el Mercado revis...
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A number the Marketplace provides when you qualify for a health insurance exemption. When you fill out an exemption application, the Marketplace will review ...
['glossary']
['glossary']
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Second lowest cost Silver plan (SLCSP)
Plan Plata con el segundo costo más bajo (SLCSP en inglés)
/glossary/second-lowest-cost-silver-plan-slcsp/
El plan del Mercado con el segundo costo más bajo en la categoría del plan Plata que le corresponda. No es necesariamente el plan en el que se inscribió. Ust...
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The second-lowest priced Marketplace health insurance plan in the Silver category that applies to you. It may not be the plan you enrolled in. You need to kn...
['glossary']
['glossary']
[]
Plan ID
Número de Identificación del Plan
/glossary/plan-id/
Cada plan médico del Mercado tiene un identificador único de 14 caracteres que es una combinación de números y/o letras.Usted puede encontrar el Número de ...
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Each Marketplace health plan has a unique 14-character identifier that's a combination of numbers and/or letters.You can find a plan's ID below the plan na...
['glossary']
['glossary']
[]
Application ID
Número de solicitud
/glossary/application-id/
Cada solicitud del Mercado tiene un número de identificación único. Luego de que haga su solicitud en el Mercado, usted recibirá una notificación con los res...
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Each Marketplace application has a unique identification number, or Application ID. After you apply for Marketplace coverage, you’ll get a notice with your e...
['glossary']
['glossary']
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Multi-State Plan
Plan multi-estatal
/glossary/multi-state-plan/
Un tipo de plan que se ofrece en el Mercado de Seguros Médicos. A pesar del nombre, "planes multi-estatales" no necesariamente tienen los proveedores de rede...
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A type of plan offered in the Health Insurance Marketplace®. Despite the name, “multi-state plans” don’t necessarily have network providers or cover services...
['glossary']
['glossary']
[]
Modified Adjusted Gross Income (MAGI)
Ingreso Bruto Ajustado Modificado (MAGI en inglés)
/glossary/modified-adjusted-gross-income-magi/
La cifra utilizada para determinar la elegibilidad para los créditos fiscales para las primas y otros ahorros en los planes médicos del Mercado y para Medica...
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The figure used to determine eligibility for premium tax credits and other savings for Marketplace health insurance plans and for Medicaid and the Children's...
['glossary']
['glossary']
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Referral
Referido
/glossary/referral/
Una orden por escrito de su médico de cuidados primarios para que usted visite un especialista u obtenga ciertos servicios médicos. En muchas Organizaciones ...
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A written order from your primary care doctor for you to see a specialist or get certain medical services. In many Health Maintenance Organizations (HMOs), y...
['glossary']
['glossary']
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Penalty
Multa
/glossary/penalty/
Un pago (también conocido como "penalidad," "multa" o "mandato individual") que hizo cuando declaró los impuestos si no tuvo seguro médico que calificaba com...
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A payment ("fee," "fine," "individual mandate") you made when you filed taxes if you didn't have health insurance that counted as qualifying health coverage ...
['glossary']
['glossary']
[]
Out-of-pocket maximum/limit
Gastos máximos de su bolsillo/límite
/glossary/out-of-pocket-maximum-limit/
Cantidad máxima que tiene que pagar por los servicios cubiertos en un año del plan. Después de gastar esta cantidad en los deducibles, copagos y coseguros po...
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The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance for in-network care and...
['glossary']
['glossary']
[]
Out-of-Pocket Estimate
Estimado de los gastos de su bolsillo
/glossary/out-of-pocket-estimate/
Un estimado de la cantidad que pagaría de su bolsillo por los servicios médico o las medicinas. El estimado se hace antes de que su plan haya enviado el recl...
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An estimate of the amount that you may have to pay on your own for health care or prescription drug costs. The estimate is made before your health plan has p...
['glossary']
['glossary']
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Out-of-Network Copayment
Copago fuera de la red
/glossary/out-of-network-copayment/
Una cantidad fija (por ejemplo, $30) que usted paga por cuidados médicos cubierto facilitados por proveedores que no tienen un contrato con su seguro o plan ...
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A fixed amount (for example, $30) you pay for covered health care services from providers who don't contract with your health insurance or plan. Out-of-netwo...
['glossary']
['glossary']
[]
Out-of-Network Coinsurance
Coseguro fuera de la red
/glossary/out-of-network-coinsurance/
El porcentaje (por ejemplo, el 40%) que usted paga de la cantidad autorizada por servicios médicos cubiertos facilitados por proveedores que no tienen un con...
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The percentage (for example, 40%) you pay of the allowed amount for covered health care services to providers who don't contract with your health insurance o...
['glossary']
['glossary']
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Original Medicare
Medicare Original
/glossary/original-medicare/
Medicare Original es un plan médico de pago por servicio que tiene dos partes: Parte A (seguro de hospital) y Parte B (seguro médico). Después de pagar un de...
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Original Medicare is a fee-for-service health plan that has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). After you pay a deductible...
['glossary']
['glossary']
[]
Not Yet Accredited (Health Plan)
Aún no acreditado (plan médico)
/glossary/not-yet-accredited-health-plan/
Un plan que aún no ha recibido un "sello de aprobación" por parte de una compañía independiente demostrando que cumple con los estándares nacionales de calid...
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A plan that hasn't been given a "seal of approval" by an independent company to show it meets national quality standards for health plans. There are many rea...
['glossary']
['glossary']
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Network Plan
Plan de la red
/glossary/network-plan/
Un plan de salud que tiene contratos con médicos, hospitales, farmacias y otros proveedores de salud para proporcionar a los miembros del plan servicios y su...
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A health plan that contracts with doctors, hospitals, pharmacies, and other health care providers to provide members of the plan with services and supplies a...
['glossary']
['glossary']
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Net Rental Income
Ingresos netos por rentas
/glossary/net-rental-income/
La cantidad que alguien le paga a usted para usar su propiedad, después de restar los gastos relacionados con esa propiedad. Los Ingresos de regalías incluye...
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The amount someone pays you to use your property, after you subtract the expenses you have for the property. Royalty income includes any payments you get fro...
['glossary']
['glossary']
[]
Worker's Compensation
Seguro de accidentes del trabajo/Compensación al trabajador
/glossary/workers-compensation/
Un plan de seguro que los empleadores están obligados a tener, para cubrir a los empleados que se enferman o sufren lesiones por actividades relacionadas con...
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An insurance plan that employers are required to have to cover employees who get sick or injured on the job.
['glossary']
['glossary']
[]
Vision Coverage
Cobertura de la vista
/glossary/vision-or-vision-coverage/
Cobertura de la vista es un beneficio médico que por lo menos cubre parcialmente el cuidado de la vista, como exámenes de la vista y anteojos. Todos los plan...
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A health benefit that at least partially covers vision care, like eye exams and glasses. All plans in the Health Insurance Marketplace® include vision covera...
['glossary']
['glossary']
[]
TTY
TTY
/glossary/tty/
Un TTY es un aparato de comunicación usado por personas sordas, con deficiencias auditivas, o que sufren una incapacidad grave del habla. Las personas que no...
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A TTY (teletypewriter) is a communication device used by people who are deaf, hard-of-hearing, or have severe speech impairment. People who don't have a TTY ...
['glossary']
['glossary']
[]
TRICARE
TRICARE
/glossary/tricare/
Un programa de cuidado médico para miembros de los servicios uniformados activos y retirados, y sus familias.
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A health care program for active-duty and retired uniformed services members and their families.
['glossary']
['glossary']
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Total Cost Estimate (for health coverage)
Estimado total de costos (para cobertura médica)
/glossary/total-cost-estimate/
La cantidad total estimada que usted quizás tenga que pagar por cobertura médica, el cual es estimado antes de que usted consiga esa cobertura y tenga gastos...
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The total amount you may have to pay for health plan coverage, which is estimated before you actually have the coverage and have health expenses under the co...
['glossary']
['glossary']
[]
Tax Household
Familia a efectos fiscales (unidad familiar)
/glossary/tax-household/
El contribuyente(s) y todo individuo declarado como dependiente en la declaración de impuestos federales. Una Familia a efectos fiscales puede incluir un cón...
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The taxpayer(s) and any individuals who are claimed as dependents on one federal income tax return. A tax household may include a spouse and/or dependents....
['glossary']
['glossary']
[]
Supplemental Security Income (SSI)
Seguridad de Ingreso Suplementario (SSI en inglés)
/glossary/supplemental-security-income/
Un beneficio mensual pagado por el Seguro Social a las personas con ingresos y recursos limitados, que están incapacitadas, ciegas, o tienen 65 años o más. L...
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A monthly benefit paid by Social Security to people with limited income and resources who are disabled, blind, or 65 or older. SSI benefits aren't the same a...
['glossary']
['glossary']
[]
Summary of Benefits and Coverage (SBC)
Resumen de beneficios y cobertura (SBC en inglés)
/glossary/summary-of-benefits-and-coverage/
Un resumen fácil de leer que le permite comparar lado a lado, los costos y coberturas ofrecidos por los diferentes planes médicos. Usted puede comparar sus o...
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An easy-to-read summary that lets you make apples-to-apples comparisons of costs and coverage between health plans. You can compare options based on price, b...
['glossary']
['glossary']
[]
Subsidized Coverage
Cobertura subsidiada
/glossary/subsidized-coverage/
La cobertura médica está disponibles a menor costo o sin costo para las personas con ingresos por debajo de ciertos niveles.Ejemplos de cobertura subsidiad...
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Health coverage available at reduced or no cost for people with incomes below certain levels.Examples of subsidized coverage include Medicaid and the Child...
['glossary']
['glossary']
[]
State Medical Assistance Office
Oficina estatal de asistencia médica
/glossary/state-medical-assistance-office/
Una agencia estatal a cargo del programa de Medicaid de ese estado y que puede facilitar información acerca de los programas que ayudan a las personas con in...
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A state agency in charge of the state's Medicaid program and can give information about programs in its state that help pay medical bills for people with lim...
['glossary']
['glossary']
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State Insurance Department
Departamento Estatal de Seguros
/glossary/state-insurance-department/
Una agencia estatal que regula los seguros y facilita información sobre la cobertura médica en su estado.
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A state agency that regulates insurance and can provide information about health coverage in its state.
['glossary']
['glossary']
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State Health Insurance Assistance Program (SHIP)
Programa Estatal de Asistencia sobre el Seguro Médico (SHIP en inglés)
/glossary/state-health-insurance-assistance-program/
Programa estatal que recibe dinero del gobierno federal para ofrecer asesoría local gratis en cuanto a seguros médicos, a personas que tienen Medicare.
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A state program that gets funding from the federal government to provide free local health coverage counseling to people with Medicare.
['glossary']
['glossary']
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Social Security
Seguro Social
/glossary/social-security/
Un sistema que distribuye beneficios financieros a las personas jubiladas o incapacitadas, sus cónyuges, y sus hijos dependientes, basados en los ingresos qu...
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A system that distributes financial benefits to retired or disabled people, their spouses, and their dependent children based on their reported earnings. Whi...
['glossary']
['glossary']
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Social Security Survivors Benefits
Beneficios del Seguro Social para sobrevivientes
/glossary/social-security-survivors-benefits/
Beneficios del Seguro Social (en caso de su muerte) basados en sus declaraciones que son pagados a su:Viuda/viudo con 60 años o más, o 50 años o más si su...
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Social Security benefits based on your record (if you should die) that are paid to your:Widow/widower age 60 or older, 50 or older if disabled, or any age...
['glossary']
['glossary']
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Social Security Benefits
Beneficios del Seguro Social
/glossary/social-security-benefits/
La cantidad que usted recibe mensualmente del Seguro Social por incapacidad, por jubilación (incluyendo el Retiro Ferroviario), o como sobreviviente.
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The amount you get from Social Security Disability, Retirement (including Railroad retirement), or Survivor's Benefits each month.
['glossary']
['glossary']
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Silver Health Plan
Plan médico de categoría Plata
/glossary/silver-health-plan/
Una de las 4 categorías de plan (también conocidas como “nivel de metal”) en el Mercado de Seguros Médicos. Los planes Plata están en el medio: usted paga pr...
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One of 4 categories of Health Insurance Marketplace® plans (sometimes called “metal levels”). Silver plans fall about in the middle: You pay moderate monthly...
['glossary']
['glossary']
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Service Area
Área de servicio
/glossary/service-area/
Un área geográfica donde un plan de seguro médico acepta miembros en caso que limite la inscripción según dónde residan las personas. Para los planes que lim...
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A geographic area where a health insurance plan accepts members if it limits membership based on where people live. For plans that limit which doctors and ho...
['glossary']
['glossary']
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Self-Employment Income
Ingresos como trabajador autónomo
/glossary/self-employment-income/
Los ingresos netos que usted gana por medio de su propio oficio o negocio. Por ejemplo, todo ingreso neto (ganancia) recibido de productos que usted venda o ...
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The net income you earn from your own trade or business. For example, any net income (profit) you earn from goods you sell or services you provide to others ...
['glossary']
['glossary']
[]
Retirement Benefit (Pension)
Beneficios de jubilación (pensión)
/glossary/retirement-benefit/
Un pago, o serie de pagos recibidos una vez que usted se jubila. Generalmente, la cantidad de sus ingresos por jubilación o distribuciones de pagos de una cu...
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A payment or series of payments made to you after you retire from work. Generally, the amount of your income from a pension or retirement account distributio...
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['glossary']
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Rental or Royalty Income
Ingresos por rentas y regalías
/glossary/rental-or-royalty-income/
La cantidad que alguien le paga a usted para usar su propiedad, después de restar los gastos relacionados con esa propiedad. Los Ingresos de regalías incluye...
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The amount someone pays you to use your property, after you subtract the expenses you have for the property. Royalty income includes any payments you get fro...
['glossary']
['glossary']
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Qualifying Life Event (QLE)
Eventos calificados
/glossary/qualifying-life-event/
Un cambio en su situación - como casarse, tener un bebé, o perder la cobertura médica - puede hacerle elegible para un Período Especial de Inscripción, que l...
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A change in your situation — like getting married, having a baby, or losing health coverage — that can make you eligible for a Special Enrollment Period, all...
['glossary']
['glossary']
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Prior Authorization
Autorización previa
/glossary/prior-authorization/
Aprobación por parte de un plan médico que puede ser requerida antes de que usted consiga un servicio o renueve una receta médica, para que el servicio o la ...
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Approval from a health plan that may be required before you get a service or fill a prescription in order for the service or prescription to be covered by yo...
['glossary']
['glossary']
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Premium Tax Credit
¿Qué es un "crédito fiscal para las primas"?
/glossary/premium-tax-credit/
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A tax credit you can use to lower your monthly insurance payment (called your “premium”) when you enroll in a plan through the Health Insurance Marketplace®....
['glossary']
['glossary']
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Platinum Health Plan
Plan médico Platino
/glossary/platinum-health-plan/
Una de las 4 categorías de plan (también conocidas como “nivel de metal”) en el Mercado de Seguros Médicos. Los planes Platino por lo general tienen las prim...
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One of 4 categories (or “metal levels”) of Health Insurance Marketplace® plans. Platinum plans usually have the highest monthly premiums of any plan category...
['glossary']
['glossary']
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Pension (Retirement Benefit)
Pensión (beneficio de jubilación)
/glossary/pension-retirement-benefit/
Un pago, o serie de pagos recibidos una vez que usted se jubila. Generalmente, la cantidad de sus ingresos por jubilación o distribuciones de pagos de una cu...
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A payment or series of payments made to you after you retire from work. Generally, the amount of your income from a pension or retirement account distributio...
['glossary']
['glossary']
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Notice
Aviso
/glossary/notice/
Un formulario de aviso oficial que informa a los individuos acerca del estatus de sus solicitudes, su elegibilidad para los diversos programas, u otra inform...
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An official form of communication that informs individuals about the status of their applications, their eligibility for programs, or other important informa...
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['glossary']
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Net Capital Gains
Ganancias netas sobre el capital
/glossary/net-capital-gains/
La cantidad en que sus ganancias anuales a largo plazo sobre el capital, son superiores a sus pérdidas anuales a corto plazo sobre el capital.Para consegui...
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The amount by which your total long-term capital gain for the year is more than your short-term capital loss for the year.For more information, visit http:...
['glossary']
['glossary']
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Navigator
Navegador
/glossary/navigator/
Individuos u organizaciones capacitados y aptos para facilitar ayuda al consumidor, pequeñas empresas y sus empleados, mientras buscan opciones de cobertura ...
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An individual or organization that's trained and able to help consumers, small businesses, and their employees as they look for health coverage options throu...
['glossary']
['glossary']
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Multi-Employer Plan
Plan a través de varios empleadores
/glossary/multi-employer-plan/
En general, un plan médico grupal patrocinado conjuntamente por dos empleadores o más.
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In general, a group health plan that's sponsored jointly by 2 or more employers.
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Member Survey Results
Resultados de la encuesta a los miembros
/glossary/member-survey-results/
Una encuesta hecha por la Encuesta al Consumidor sobre los Proveedores y Sistemas de Salud (CAHPS en inglés), que pide a los miembros del plan, que valoren ...
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A survey conducted by the Consumer Assessment of Healthcare Providers and Systems (CAHPS) which asks health plan members to rate the care their experiences w...
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Marketplace
Mercado de seguros
/glossary/marketplace/
Palabra corta para decir "Mercado de Seguros Médicos," un servicio de compras e inscripción para el seguro médico creado por la Ley de Cuidado de Salud a Baj...
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Shorthand for the “Health Insurance Marketplace®,” a shopping and enrollment service for medical insurance created by the Affordable Care Act in 2010.In mo...
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Large Group Health Plan
Plan médico grupal grande
/glossary/large-group-health-plan/
En general, un plan grupal que cubre empleados de un empleador con 51 empleados o más. En algunos estados, los grandes grupos se definen como grupos con 101 ...
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In general, a group health plan that covers employees of an employer that has 51 or more employees. In some states large groups are defined as 101 or more.
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Investment Income
Ingresos por inversiones
/glossary/investment-income/
Los ingresos que usted recibe por una inversión, tales como interés recibido de un banco o, dividendos recibidos de unas acciones.Para más información, vea...
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The income you get from an investment, like interest you get from a bank or dividends you get from a stock you own.For more information, see IRS Publicatio...
['glossary']
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Interest
Interés
/glossary/interest/
El costo por conseguir dinero prestado.El interés que se cobra de un banco, o dividendos percibidos de una acción de la cual usted es propietario, son algu...
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The charge for the use of borrowed money.Interest you get from a bank or dividends from a stock you own are examples of investment income, which you should...
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Inpatient Care
Cuidados para paciente internado
/glossary/inpatient-care/
Cuidados médicos que usted recibe cuando es internado en un centro médico, tal como un hospital o un centro de enfermería especializado.
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Health care that you get when you're admitted as an inpatient to a health care facility, like a hospital or skilled nursing facility.
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In Person Assistance Personnel Program
Asistencia/Personal
/glossary/in-person-assistance-personnel-program/
Individuos u organizaciones capacitados y aptos para facilitar ayuda al consumidor, pequeñas empresas y sus empleados, mientras buscan opciones de cobertura ...
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Individuals or organizations that are trained and able to provide help to consumers, small businesses, and their employees as they look for health coverage o...
['glossary']
['glossary']
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Health Plan Categories
Categorías de planes médicos
/glossary/health-plan-categories/
Los niveles de planes en el Mercado de Seguros Médicos: Bronce, Plata, Oro y Platino. Las categorías (algunas veces llamadas “nivel de metal”) son basadas en...
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Levels of plans in the Health Insurance Marketplace®: Bronze, Silver, Gold, and Platinum. Categories (sometimes called “metal levels”) are based on how you a...
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Health Coverage
Cobertura médica
/glossary/health-coverage/
Derecho legal al pago o reembolso de sus costos por atención médica, por lo general mediante un contrato con una compañía de seguro, un plan de salud grupal ...
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Legal entitlement to payment or reimbursement for your health care costs, generally under a contract with a health insurance company, a group health plan off...
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Hardship Exemption
Exención por dificultad
/glossary/hardship-exemption/
Una exención que se necesita al solicitar cobertura catastrófica para las personas de 30 años o más que enfrentaron una "dificultad" que les impidió obtener ...
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An exemption that’s needed when applying for Catastrophic coverage for people 30 and older who faced a "hardship" that prevented them from getting insurance....
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Group Health Plan
Plan médico grupal
/glossary/group-health-plan/
En general, un plan de salud ofrecido por un empleador o una organización de empleados, que provee cobertura médica a los empleados y sus familias.
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In general, a health plan offered by an employer or employee organization that provides health coverage to employees and their families.
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Gold Health Plan
Plan médico de categoría Oro
/glossary/gold-health-plan/
Una de las 4 categorías de plan (también conocidas como “nivel de metal”) en el Mercado de Seguros Médicos. Los planes Oro por lo general tienen primas mensu...
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One of 4 health plan categories (or “metal levels”) in the Health Insurance Marketplace®. Gold plans usually have higher monthly premiums but lower costs whe...
['glossary']
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Generic Drugs
Medicamento genérico
/glossary/generic-drugs/
Un medicamento recetado que tiene la misma fórmula de ingredientes activos que un medicamento de marca. Los medicamentos genéricos usualmente cuestan menos q...
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A prescription drug that has the same active-ingredient formula as a brand-name drug. Generic drugs usually cost less than brand-name drugs. The Food and Dru...
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Full-Time Employee (FTE)
Empleado a tiempo completo
/glossary/full-time-employee/
Cualquier empleado que trabaja un promedio de al menos 30 horas por semana durante más de 120 días en un año. Los empleados a tiempo parcial que trabajan un ...
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Any employee who works an average of at least 30 hours per week for more than 120 days in a year. Part-time employees work an average of less than 30 hours p...
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Fee
Tarifa
/glossary/fee/
Un pago (también conocido como "penalidad," "multa" o "mandato individual") que hizo cuando presenta su declaración federal de impuestos si no tuvo seguro mé...
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A payment ("penalty," "fine," "individual mandate") you made when you filed federal taxes if you didn't have health insurance that counted as qualifying heal...
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Fee for Service
Pago por servicio
/glossary/fee-for-service/
Método en el cual se paga a los médicos y otros proveedores de servicios de salud por cada servicio brindado. Algunos ejemplos de servicios incluyen pruebas ...
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A method in which doctors and other health care providers are paid for each service performed. Examples of services include tests and office visits.Related...
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Federally Recognized Tribe
Tribu reconocida federalmente
/glossary/federally-recognized-tribe/
Cualquier tribu, corporación Alaska Native Claims Settlement Act (ANCSA ) (de un región o pueblo), grupo, nación, pueblo, comarca o comunidad indígena o de n...
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Any Indian or Alaska Native tribe, Alaska Native Claims Settlement Act (ANCSA) Corporation (regional or village), band, nation, pueblo, village, rancheria, o...
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External Review
Revisión externa
/glossary/external-review/
Una revisión de la decisión de un plan de denegación de cobertura o pago de un servicio, llevada a cabo por una organización independiente, no relacionada co...
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A review of a plan's decision to deny coverage for or payment of a service by an independent third-party not related to the plan. If the plan denies an appea...
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Employer or Union Retiree Plans
Planes de empleadores o sindicatos para jubilados
/glossary/employer-or-union-retiree-plans/
Planes que ofrecen cobertura de salud y/o de medicamentos a ex-empleados o miembros y en algunos casos, a sus familias. Estos planes se ofrecen a las persona...
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Plans that provide health and/or drug coverage to former employees or members, and, in some cases, their families. These plans are offered to people through ...
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Eligible Immigration Status
Estatus de inmigración elegible
/glossary/eligible-immigration-status/
Una condición inmigratoria que se considera elegible para obtener cobertura médica a través del Mercado de seguros. Las reglas sobre la condición inmigratori...
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An immigration status that's considered eligible for getting health coverage through the Marketplace. The rules for eligible immigration status may be differ...
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Eligibility Assessment
Evaluación de elegibilidad
/glossary/eligibility-assessment/
En algunos estados, el Mercado de seguros no provee la decisión final en cuanto a la elegibilidad para Medicaid. Sin embargo, el Mercado de seguros lleva a c...
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In certain states, the Marketplace doesn't provide the final decision on Medicaid eligibility. Instead, the Marketplace conducts an assessment and passes the...
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Drug List
Lista de medicamentos (Formulario)
/glossary/drug-list/
Una lista de medicamentos recetados cubiertos por un plan de medicamentos recetados u otro plan de seguro médico que ofrezca beneficios de medicamentos recet...
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A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Also called a formulary.
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Domestic Partnership
Pareja doméstica/de hecho
/glossary/domestic-partnership/
Dos personas del mismo o diferente sexo que viven juntos y comparten una vida doméstica, pero no están casadas o unidas por una unión civil. En algunos estad...
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Two people of the same or opposite sex who live together and share a domestic life, but aren't married or joined by a civil union. In some states, domestic p...
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Dividend
Dividendo
/glossary/dividend/
Un pago hecho por una corporación con fines de lucro a sus accionistas. Este pago es una porción de los beneficios corporativos y se puede pagar un cierto nú...
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A payment made by a for-profit corporation to its shareholders. This payment is a portion of the corporate earnings and may be paid a certain number of times...
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Dependent
Dependiente
/glossary/dependent/
Un niño u otra persona en virtud de la cual los padres, parientes u otra persona pueden reclamar una exención personal de impuestos. En virtud de la Ley de a...
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A child or other individual for whom a parent, relative, or other person may claim a personal exemption tax deduction. Under the Affordable Care Act, individ...
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Department of Health and Human Services (HHS)
Departamento de Salud y Servicios Humanos (HHS en inglés)
/glossary/department-of-health-and-human-services-hhs/
La agencia federal que supervisa el programa CMS, el cual administra los programas de protección de la salud de todas las personas en los Estados Unidos, inc...
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The federal agency that oversees CMS, which administers programs for protecting the health of all Americans, including Medicare, the Marketplace, Medicaid, a...
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Dental Coverage
¿Puedo obtener cobertura dental del Mercado?
/glossary/dental-coverage/
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Benefits that help pay for the cost of visits to a dentist for basic or preventive services, like teeth cleaning, X-rays, and fillings. In the Marketplace, d...
['glossary']
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Deductible
Deducible
/glossary/deductible/
La cantidad que paga por los servicios de atención médica cubiertos antes de que su plan de seguro comience a pagar. Con un deducible de $2,000, usted paga l...
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The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000...
['glossary']
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Court Awards
Adjudicaciones judiciales
/glossary/court-awards/
El dinero que es debido como resultado de una demanda. Este dinero puede ser libre de impuestos. Ejemplos de adjudicaciones libres de impuestos son las canti...
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Money that's due to you as the result of a lawsuit. This money may be taxable. Examples of lawsuit proceeds that aren't taxable are amounts awarded to you fo...
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Cost Sharing Reduction (CSR)
Reducción de Costos Compartidos
/glossary/cost-sharing-reduction/
Un descuento que disminuye la cantidad que tiene que pagar de su bolsillo por deducibles, copagos y coseguros. En el Mercado de Seguros Médicos, las reduccio...
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A discount that lowers the amount you have to pay for deductibles, copayments, and coinsurance. In the Health Insurance Marketplace®, cost-sharing reductions...
['glossary']
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Coordination of Benefits
Coordinación de beneficios
/glossary/coordination-of-benefits/
Una forma de averiguar quién paga primero cuando 2 o más planes de seguro médico son responsables de pagar la misma reclamación médica.
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A way to figure out who pays first when 2 or more health insurance plans are responsible for paying the same medical claim.
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Co-op
Cooperativa
/glossary/co-op/
Una organización sin fines de lucro en la que los propios dueños están asegurados por la compañía. Las cooperativas pueden estar formadas a nivel nacional, e...
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A non-profit organization in which the same people who own the company are insured by the company. Cooperatives can be formed at a national, state, or local ...
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Certified Application Counselor
Consejeros certificados para solicitudes
/glossary/certified-applicant-counselor/
Un individuo (afiliado con una organización designada) que está capacitado y puede ayudar a los consumidores, pequeñas empresas, y a sus empleados que buscan...
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An individual (affiliated with a designated organization) who is trained and able to help consumers, small businesses, and their employees as they look for h...
['glossary']
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Centers for Medicare & Medicaid Services (CMS)
Centros de Servicios de Medicare y Medicaid (CMS en inglés)
/glossary/centers-for-medicare-and-medicaid-services/
La agencia federal que administra los programas Medicare, Medicaid y el Programa de seguro médico para los niños, y el Mercado de seguros médicos facilitado ...
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The federal agency that runs the Medicare, Medicaid, and Children's Health Insurance Programs, and the federally facilitated Marketplace. For more informatio...
['glossary']
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Capital Gains
Ganancias sobre el capital
/glossary/capital-gains/
Una ganancia sobre el capital es la cantidad que usted recibe de la venta de una propiedad, tal como acciones, una casa, o un fondo mutuo. Por ejemplo, si us...
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A capital gain is the amount you get from selling property, like stock, a house, or a mutual fund. For example, if you buy stock for $1,000 and sell it for $...

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