21 Health Insurance Acronyms Explained
Health insurance folks are big fans of using acronyms. It's totally fine if you work in the industry, but for customers, it can sound like a whole lot of gibberish. We've put together a list of 21 acronyms and terms commonly used in health insurance to help you make sense of it all with super short explanations.
Looking for a deeper explanation? Try our glossary.
- ABA - Applied Behavior Analys is a therapy used to help individuals with autism and other developmental disorders by focusing on behavior patterns to improve their social, communication, and learning skills.
- ACA - Affordable Care Act is also referred to by other names like Obamacare. It's the major healthcare legislation that created a federal health insurance marketplace.
- ASC - Ambulatory Surgery Center is a fancy way to say outpatient surgery center. These are medical facilities that offer less complicated surgeries and where you don't stay overnight.
- ASD - Autism Spectrum Disorder is a developmental condition that affects how people communicate, interact with others, and experience the world around them.
- ED - Emergency Department also known as ER or emergency room.
- EHB - Essential Health Benefits are a set of healthcare services and benefits that must be covered by insurance plans under the ACA. (There we go with another acronym!)
- EPO - Exclusive Provider Organization AKA a type of health plan.
- ESI - Employer-Sponsored Insurance or health insurance provided by the companies/employers.
- FDA - Food and Drug Administration is the U.S. government agency that monitors medicines (among other things.)
- HHS - Department of Health and Human Services is the U.S. government agency that oversees public health.
- HIPAA - Health Insurance Portability and Accountability Act is a law to ensure our health details remain private.
- HMO - Health Maintenance Organization AKA a type of health plan.
- HRA - Health Reimbursement Arrangement is a type of benefit that reimburses employees for qualified medical expenses.
- ICHRA - Individual Coverage Health Reimbursement Arrangement is what StretchDollar offers allowing employers to give pre-tax dollar to employees to purchase health insurance.
- IOP - Intensive Outpatient Program is a treatment program for mental health or substance use issues.
- IRS - Internal Revenue Service is the U.S. government agency responsible for taxes.
- OOP - “out-of-pocket," is the amount of money you have to pay from your own pocket for healthcare expenses that your insurance doesn't cover.
- OTC - Over-the-Counter refers to non-prescription medications and products.
- PCP - Primary Care Physician is your main doctor.
- PPO - Preferred Provider Organization AKA a type of health plan
- QHP - Qualified Health Plan is a plan that meets the ACA requirements. (Ah, an acronym with an acronym.)
- QLE: Qualifying Life Events create an SPE (see acronym below) which allows you to purchase health insurance outside of the specified open enrollment period (Nov 1 - Dec 15.)
- QSEHRA - Qualified Small Employer Health Reimbursement Arrangement is like an ICHRA except there are limits on how much you can give an employee per year.
- SPE: Special Enrollment Period is the time frame when individuals can enroll or make changes to their health insurance plans due to a QLE.
Check out our glossary for detailed definitions.