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We Asked 15 People To Define These Health Insurance Terms

There's a lot you may not know — like the fact you have to report your health insurance status on your 2014 taxes this year. Get smart about health insurance, and make sure you're prepared by visiting

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3. com·mu·ni·ty rat·ing (n.) — "A scale of one to five stars that tells you what your neighbors think of you."

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What it actually means: A rule that prohibits health insurance providers from charging different rates within a region based on age, gender, or health status.

4. de·duct·i·ble (n.) — "An item you're willing to remove from your shopping cart."

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What it actually means: The amount you have to pay yourself before your health insurance begins to pay. The deductible only counts toward covered health services.

5. es·sen·tial health ben·e·fits (n.) — "What you get from using daily skin moisturizers."

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What it actually means: A set of health services all insurance policies must cover, including hospitalization, prescriptions, maternity care, rehabilitation, and others.

7. ex·emp·tions (n.) — "Excuses you used to get out of gym class in high school."

Peter Dutton (CC BY http://2.0) / Via Flickr: joeshlabotnik

What it actually means: A reason for not having health coverage. The ACA requires a penalty on your 2014 taxes if you're uninsured, but there are exceptions.

9. med·i·cal un·der·wri·ting (v.) — "The language doctors use when writing prescriptions."

Grigorij Rasputin (CC0) / Via

What it actually means: The process of determining your health status — used by insurance providers to decide if they should offer you coverage, and at what cost.

10. met·al tiers (n.) — "The ascending layers of a heavy metal cake."

Linda Marklund (CC BY http://2.0) / Via Flickr: 51226001@N03

What it actually means: The health plan categories in the Marketplace — Bronze, Silver, Gold, and Platinum. Each plan dictates the amount you'll spend annually.

12. out-of-pock·et (a.) — "When you forget your gloves and are still willing to get frostbite so you can play on your phone."


What it actually means: The medical expenses you pay for yourself, like co-pays and annual deductibles. The costs that aren't reimbursed by your insurance.

13. pen·al·ty (n.) — "Something that happens in soccer, I think?"

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What it actually means: If you don't have health insurance after February 15, 2015, you'll have to pay a penalty fee on your tax return, barring possible exemptions.

14. qual·i·fied health plan (n.) — "When your health plan makes the quarter finals."


What it actually means: "An insurance plan that is certified by the Health Insurance Marketplace, provides essential health benefits, and meets other requirements."

Are you covered for 2015? Brush up on your health insurance terms and get personalized info at