More info: https://help.ahpcare.com/hc/en-us/sections/360008116033-Glossary-of-Common-Health-Insurance-Terms
The Affordable Care Act (ACA) - Federal law that requires most people in the U.S. to have health insurance that meets certain requirements. (link to ACA requirements); Also known as PPACA.
Academic Blue - Another name for SSHIP/Grad Plan
Academic Health Plans (AHP) - The company that handles enrollment, waiver processing, and information on SSHIP and Grad Plan
Academic Emergency Services (AES) - Insurance coverage that provides medical evacuation and repatriation coverage, among other services. It can be bought in addition to other health insurance to meet TAMU requirements.
Alternate Equivalent Coverage - Health insurance coverage that is sufficient to grant a waiver from SSHIP.
A.P. Beutel Health Center – College Station Student Health Center
Benefits - The services, treatments, and medical devices that health insurance will pay for. Benefits often require that the Insured pay co-insurance, a co-payment, and/or a deductible before the insurance will pay.
Blue Access for Members (BAM) - Online web portal where those with SSHIP, Grad Plan, or a TAMU employee plan can find information about their health insurance.
Blue Card – Program that provides you access to healthcare services and BCBSTX payment of benefits when outside the covered area. i.e. if you are traveling outside of Texas this program ensures that BCBSTX pays for your care as if you were in Texas.
Blue Cross Blue Shield of Texas (BCBSTX) - The company that provides SSHIP, Grad Plan, and TAMU employee plans.
Coverage Period – The period that the insurance is in effect. This is usually for a period of several months. For example, the SSHIP has coverage periods of 09/01/19 - 12/31/19 for Fall and 01/01/20 - 08/31/20 for Spring/Summer
Deductible - Amount that the Insured must pay Out-of-Pocket before benefits will be paid. When a deductible is "waived" it means that one does not need to pay it before benefits will be paid.
Dental Insurance – Insurance that covers most dental care. If enrolling in SSHIP or Grad Plan dental insurance must be purchased separately. This can be done at https://tamu.myahpcare.com/
Dependent – A person, such as a spouse or child, that gets health insurance through another person. A student or employee might enroll their spouse or children as dependents in SSHIP, Grad Plan, or other health insurance. Adding a dependent increases the premium and may affect the policy's deductible.
Exclusions & Limitations – The medical expenses, treatments, services, devices, etc. that the plan will not pay for. These will be listed in your policy materials. Also called: Excluded Services
Fall Mandatory First Time On-Campus Arrival - The period that first-time students are required to be on campus before the beginning of the first coverage period. This period will require health insurance just like any other. SSHIP will automatically be billed to students, but students can obtain a waiver through the standard waiver process.
Grad Plan – The plan offered to students with a graduate assistantship. Enrollment in this plan will remove the fee for SSHIP if coverage starts on or before September 1st in the Fall coverage period or January 31st in the Spring/Summer coverage period. If enrollment occurs after these dates the student will receive a refund for months of double coverage in the following semester.
Graduate Student Employee (GSE) – Any person who is both enrolled as a graduate student and working as a benefits-eligible employee at Texas A&M.
Group Number - A number that identifies the employer or group plan that you are a member of.
Health Information Portability and Accountability Act (HIPAA) – Health Information Portability and Accountability Act; federal which protects your private health information from being shared.
Inpatient – You are an inpatient if you are staying at a hospital for treatment.
Member ID – A number that identifies you and your membership to a health insurance plan. For SSHIP & Grad Plan enrollees this number should be ZGP + your UIN. For other TAMU employee plans, the number is TXW + your UIN.
Network Provider – A hospital, doctor, or other provider that an insurance company has a contract with. The intent of such contracts is to reduce costs. Receiving care at a Network Provider will be cheaper in most cases. Also called In-Network Provider.
Open Enrollment Period –The period when you and your dependents can be enrolled in an insurance plan and have an opportunity to make changes to their health insurance coverage each year. If you need to make changes outside of the designated enrollment period, you can only do so within 60 days of a “qualifying event” (see definition below).
Out-of-Network Provider – Any hospital, doctor, or other provider that an insurance company does not have a contract with. Care at Out-of-Network Providers will likely be more expensive.
Outpatient – You are an outpatient if you receive care but are not admitted to the hospital, or if you receive services in an emergency, or any other circumstance where you are not considered an Inpatient.
Out-of-pocket – Cost of a service, treatment, medical devices, etc. that the insured is responsible for paying. This can include co-insurance, co-payments, and deductibles.
Qualifying Event – Qualifying events are the circumstances when you can enroll in health insurance or add a dependent outside of the open enrollment period. This potentially includes getting married, the birth or adoption of a child, or the loss of insurance from another source.
Referral- A referral is formal way to recommend the services of a health provider. Some Providers only accept patients with a referral from another provider. Sometimes your Health Insurance Plan my require you get a referral to see certain providers.
Student Health Services - A collection of health services offered on-campus to Texas A&M students. Services obtained here are often free or cheaper for students. Services include prescription drugs, preventative medicine, physical therapy, doctor appointments, and Emergency Services among others. Employees have limited access to the services at SHS. Note that F-2 and J-2 dependents are not eligible for services at Student Health Services.
System Student Health Insurance Plan (SSHIP) - The health insurance that all students are automatically enrolled in. This is done to ensure that students do not violate their visa status or TAMU system regulations by having gaps in health insurance coverage. The cost of the plan is charged to the student's tuition. Students who wish to not pay for SSHIP must show proof of equivalent coverage via the waiver process.
Telemedicine – Telemedicine is when you receive medical services from a doctor or other health professional through telecommunication technology like video conferencing, Virtual Visits, or online chats.
Virtual Visits – Service offered by SSHIP, Grad plan, and other employee plans to have non-emergency medical appointments and mental health counseling using telemedicine.
Waiver – Document you need to avoid an SSHIP fee or have it refunded.
The Affordable Care Act (ACA) - Federal law that requires most people in the U.S. to have health insurance that meets certain requirements. (link to ACA requirements); Also known as PPACA.
Academic Blue - Another name for SSHIP/Grad Plan
Academic Health Plans (AHP) - The company that handles enrollment, waiver processing, and information on SSHIP and Grad Plan
Academic Emergency Services (AES) - Insurance coverage that provides medical evacuation and repatriation coverage, among other services. It can be bought in addition to other health insurance to meet TAMU requirements.
Alternate Equivalent Coverage - Health insurance coverage that is sufficient to grant a waiver from SSHIP.
A.P. Beutel Health Center – College Station Student Health Center
Benefits - The services, treatments, and medical devices that health insurance will pay for. Benefits often require that the Insured pay co-insurance, a co-payment, and/or a deductible before the insurance will pay.
Blue Access for Members (BAM) - Online web portal where those with SSHIP, Grad Plan, or a TAMU employee plan can find information about their health insurance.
Blue Card – Program that provides you access to healthcare services and BCBSTX payment of benefits when outside the covered area. i.e. if you are traveling outside of Texas this program ensures that BCBSTX pays for your care as if you were in Texas.
Blue Cross Blue Shield of Texas (BCBSTX) - The company that provides SSHIP, Grad Plan, and TAMU employee plans.
Coverage Period – The period that the insurance is in effect. This is usually for a period of several months. For example, the SSHIP has coverage periods of 09/01/19 - 12/31/19 for Fall and 01/01/20 - 08/31/20 for Spring/Summer
Deductible - Amount that the Insured must pay Out-of-Pocket before benefits will be paid. When a deductible is "waived" it means that one does not need to pay it before benefits will be paid.
Dental Insurance – Insurance that covers most dental care. If enrolling in SSHIP or Grad Plan dental insurance must be purchased separately. This can be done at https://tamu.myahpcare.com/
Dependent – A person, such as a spouse or child, that gets health insurance through another person. A student or employee might enroll their spouse or children as dependents in SSHIP, Grad Plan, or other health insurance. Adding a dependent increases the premium and may affect the policy's deductible.
Exclusions & Limitations – The medical expenses, treatments, services, devices, etc. that the plan will not pay for. These will be listed in your policy materials. Also called: Excluded Services
Fall Mandatory First Time On-Campus Arrival - The period that first-time students are required to be on campus before the beginning of the first coverage period. This period will require health insurance just like any other. SSHIP will automatically be billed to students, but students can obtain a waiver through the standard waiver process.
Grad Plan – The plan offered to students with a graduate assistantship. Enrollment in this plan will remove the fee for SSHIP if coverage starts on or before September 1st in the Fall coverage period or January 31st in the Spring/Summer coverage period. If enrollment occurs after these dates the student will receive a refund for months of double coverage in the following semester.
Graduate Student Employee (GSE) – Any person who is both enrolled as a graduate student and working as a benefits-eligible employee at Texas A&M.
Group Number - A number that identifies the employer or group plan that you are a member of.
Health Information Portability and Accountability Act (HIPAA) – Health Information Portability and Accountability Act; federal which protects your private health information from being shared.
Inpatient – You are an inpatient if you are staying at a hospital for treatment.
Member ID – A number that identifies you and your membership to a health insurance plan. For SSHIP & Grad Plan enrollees this number should be ZGP + your UIN. For other TAMU employee plans, the number is TXW + your UIN.
Network Provider – A hospital, doctor, or other provider that an insurance company has a contract with. The intent of such contracts is to reduce costs. Receiving care at a Network Provider will be cheaper in most cases. Also called In-Network Provider.
Open Enrollment Period –The period when you and your dependents can be enrolled in an insurance plan and have an opportunity to make changes to their health insurance coverage each year. If you need to make changes outside of the designated enrollment period, you can only do so within 60 days of a “qualifying event” (see definition below).
Out-of-Network Provider – Any hospital, doctor, or other provider that an insurance company does not have a contract with. Care at Out-of-Network Providers will likely be more expensive.
Outpatient – You are an outpatient if you receive care but are not admitted to the hospital, or if you receive services in an emergency, or any other circumstance where you are not considered an Inpatient.
Out-of-pocket – Cost of a service, treatment, medical devices, etc. that the insured is responsible for paying. This can include co-insurance, co-payments, and deductibles.
Qualifying Event – Qualifying events are the circumstances when you can enroll in health insurance or add a dependent outside of the open enrollment period. This potentially includes getting married, the birth or adoption of a child, or the loss of insurance from another source.
Referral- A referral is formal way to recommend the services of a health provider. Some Providers only accept patients with a referral from another provider. Sometimes your Health Insurance Plan my require you get a referral to see certain providers.
Student Health Services - A collection of health services offered on-campus to Texas A&M students. Services obtained here are often free or cheaper for students. Services include prescription drugs, preventative medicine, physical therapy, doctor appointments, and Emergency Services among others. Employees have limited access to the services at SHS. Note that F-2 and J-2 dependents are not eligible for services at Student Health Services.
System Student Health Insurance Plan (SSHIP) - The health insurance that all students are automatically enrolled in. This is done to ensure that students do not violate their visa status or TAMU system regulations by having gaps in health insurance coverage. The cost of the plan is charged to the student's tuition. Students who wish to not pay for SSHIP must show proof of equivalent coverage via the waiver process.
Telemedicine – Telemedicine is when you receive medical services from a doctor or other health professional through telecommunication technology like video conferencing, Virtual Visits, or online chats.
Virtual Visits – Service offered by SSHIP, Grad plan, and other employee plans to have non-emergency medical appointments and mental health counseling using telemedicine.
Waiver – Document you need to avoid an SSHIP fee or have it refunded.