Health and Self-Care for Artists

Health and Emergency Resource Glossary

The following is a non-exhaustive list of words that we think are important to understand regarding health and emergency related resources.

Affordable Care Act – The comprehensive health care reform law enacted in March 2010 (sometimes known as ACA, PPACA, or “Obamacare”). The law has 3 primary goals: 1. Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level. 2. Expand the Medicaid program to cover all adults with income below 138% of the federal poverty level. (Not all states have expanded their Medicaid programs.) 3. Support innovative medical care delivery methods designed to lower the costs of health care generally. (Source)

Coinsurance – A fixed amount – typically expressed in percentage terms – of each medical bill that you pay yourself, above your deductible. Together, copayments and coinsurance are called out of pocket costs. (Source)

Copayment – aA small amount of each medical bill that, once you have exceeded your deductible, you still have to pay out of pocket. Copayments are typically seen at doctors’ offices or when filling prescriptions, and are a fixed amount – typically something like $20 per visit, or $10 per prescription. (Source)

Counselor – A counselor’s primary focus is talking to you to help you overcome your problems. This is commonly referred to as “talk therapy”. Talk therapy helps by assisting you with processing negative thoughts, looking at life from a different angle or discovering more productive ways to react to events or toxic people in your life. Counselors cannot prescribe medication. Should you need medications, they can refer you to a psychiatrist. (Source)

Deductible – The amount you are required to pay before your health insurance kicks in. A plan with a $2,000 deductible, you’ll have to pay the first $2,000 of medical bills before the insurance company covers anything.(Source)

Exclusive Provider Organization (EMO) – Allows you to see any medical provider within the network, but typically does not require a referral, and therefore a primary care doctor is not required either. EMOs are more flexible than HMOs, but are generally a bit more expensive, but not as expensive as a PPO (see below), because an EMO won’t cover out-of-network medical providers. (Source)

Federally Qualified Health Centers – According to the Health Resources and Services Administration (HRSA), FQHCs: Qualify for funding under Section 330 of the Public Health Service Act (PHS); Qualify for enhanced reimbursement from Medicare and Medicaid, as well as other benefits; Serve an underserved area or population; Offer a sliding fee scale; Provide comprehensive services (either on-site or by arrangement with another provider), including: Preventive health services, Dental services, Mental health and substance abuse services, Transportation services necessary for adequate patient care, Hospital and specialty care; Have an ongoing quality assurance program; Have a governing board of directors. (Source)

Health Maintenance Organization (HMO) – Your care must be coordinated by a primary care doctor who issues referrals to specialists on an as-needed basis. Typically, the doctors in an HMO plan are employed by the HMO, which also operates its own medical facilities. The result is a cost efficient and highly convenient approach to healthcare, but also one that is fairly limited, since HMOs won’t cover the cost of medical providers outside of their own network, except in emergencies. (Source)

Preferred Provider Organization (PPO) – Offers the most flexibility in terms of medical providers, but you pay for the convenience: PPO plans are also typically the most expensive among health insurance options. A PPO is the most flexible because you can see any medical provider you want without a referral, and in most cases, the insurance company will even pay for providers that are out of its network, just at a significantly reduced rate. (Source)

Psychiatrist – A psychiatrist is a doctor who prescribes psychiatric medications to its patients. Typically you won’t receive lots of “talk therapy” from a psychiatrist. They are more focused on providing you with medications. (Source)

Psychologist – A clinical psychologist is a professional who has earned a PhD or a PsyD in clinical psychology. In most states, psychologists cannot prescribe medication, but are trained to work with individuals who have either mild or severe psychological issues. Some psychologists do not work as therapists, but instead teach at universities or conduct psychological research. (Source)

Social Worker – Social workers often focus on solving social problems and connecting clients with appropriate resources. (Source)