High Deductible Health Plan (HDHP)

Health plan product that combines a health savings account (HSA) with traditional medical coverage. Typically include higher annual deductibles and out-of-pocket maximums, but preventative care services are fully covered and enrollees are often charged a lower monthly premium.

In Network

Facilities, providers, and suppliers like doctors, hospitals, and pharmacies that your health insurance company contracts with to provide health care at a discounted rate.

Incontestable Clause

A policy provision in which the company agrees not to contest the validity of the contract after it has been in force for a certain period of time, usually two years.

Indemnity

A payment to an insurance plan enrollee, generally a fixed amount per hospital day. Common to insurance plans in the 1900s.

Indian Health Service (IHS)

A federal agency under the Department of Health and Human Services (HHS) established to provide healthcare to federally recognized American Indians, Alaska Natives, and their descendants. Like the VHA, it is not a health insurance plan.

Individual Mandate

A policy under the Affordable Care Act requiring most Americans to have health insurance or to pay a penalty. The penalty is capped at the cost of a bronze plan (see Precious Metal Categories).

Individual Marketplace

A health insurance marketplace where individual patients and their families can compare plans, apply for subsidies, determine eligibility for government-sponsored plans, and potentially enroll in those plans. Coverage must be purchased during the Open Enrollment period. Also called a health insurance exchange.

Insurance

A financial guarantee against an unforseen event. Generally small payments are provided over time, and an insurance provider pays a large sum to the covered person in the event of disaster or disability

Insured

The policyholder; the person(s) protected in case of a loss or claim.

Insurer

The insurance provider.

International Classification of Diseases (ICD), 10th Edition

A standardized list of medical procedures and diagnoses. Codes from this list are used by healthcare professionals to bill insurance companies based on the needs of each patient. Clinical Modification and Procedure Coding System numbers are added to make each code seven digits long. Abbreviated ICD-10.

List Price

The "menu price" of a healthcare service, medication, or item as reported by a hospital or physician, that a patient would pay in full if not covered by insurance. List prices can often be negotiated down by those without insurance.