21 Health Insurance Acronyms Explained

Understanding healthcare language is hard enough without all those acronyms. We explain the alphabet soup here.

Key takeaways

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 Analysis 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 dollars 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.