Bariatric surgery: stomach stapling, gastric bypass, weight-loss surgery.
Burning barn insurance: When your barn catches fire, you immediately call the Allstate office upwind for a quote. In our context, this is the tendency for people to only buy insurance when they anticipate that there will be a need for it (also known as adverse selection).
CAT scan: Computerized axial tomography, used to look inside your body and see just where the cheeseburgers are blocking your arteries.
Co-insurance: The percentage of medical expenses not covered by your insurance; in an 80/20 plan such as Medicare, for example, the 20% is your coinsurance.
Co-payment: A payment charged to you when you see a doctor. Differs from co-insurance in that it is fixed; you will pay the same co-payment at every doctor’s visit regardless of the services you receive.
Contractual adjustment: A discount that is applied to the doctor’s fee by the insurance carrier in order for the doctor to participate in the insurance carrier’s network. Typically around 40% of the doctor’s gross bill.
Deductible: An amount charged to you before your insurance will begin to pay.
Flexible spending account (FSA): A plan which allows employees to put money into an account pre-tax to be used for medical expenses. This money must be spent in the tax year in which it is deducted.
Health Savings Account (HSA): A plan which allows employees to put money into an account pre-tax to be used for medical expenses. Differs from an FSA in that the money in the account can be carried over from year to year.
In-network: A physician who participates with a particular insurance carrier.
Medicaid: Government insurance plan for low-income people.
Medicare: Government insurance plan for senior citizens and the disabled.
Out-of-network: A physician who does not participate with a particular insurance carrier.
Palliative care: Care that is intended to relieve pain only; not curative or therapeutic treatment.
Participation: When a doctor agrees to accept an insurance carrier’s discounted rate (plus co-payments and co-insurance, if any) as payment in full for services rendered.
Primary care physician: A patient’s usual physician, typically seen for routine exams and minor medical issues.
Specialist: A physician with specialized education and/or training in a particular field of medicine. Also a bad movie starring Sylvester Stallone.