HC
HealthCheck
EPSDT in Wisconsin for people under 21. Covers the member’s well-child check, follow-up visits, and special appointments.
Common Terms, Acronyms, and Shorthands
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H
HCOS
HealthCheck Other Services
The Wisconsin Medicaid term for a federal requirement to allow coverage of services that are not routinely covered, but are medically necessary to prevent, correct, improve, or maintain a child’s physical or mental condition. Usually, prior authorization is required since the determination of medical necessity is made on a case-by-case basis, depending on the needs of the child.
HIRSP
Health Insurance Risk Sharing Plan
An insurance plan that offers coverage to individuals with adverse medical histories and other who cannot obtain affordable health care coverage from the private sector.
HMO
Health Maintenance Organization
Insurance programs offered through a private company that provides care through a specific network of doctors and hospitals for a fixed fee. Typically paying a copay for services and must stay in-network for coverage (except for emergencies). Provided with a designated Primary Care Provider, referrals to specialists are required.
e.g. Blue Cross Blue Shield, United Healthcare, Group Health Cooperative
Hospital Indemnity Insurance
Hospital indemnity insurance provides a fixed daily, weekly or monthly benefit while the insured is confined in a hospital. The payment is not dependent on actual hospital charges, and is most commonly a flat dollar amount. Hospital indemnity benefits are paid in addition to any other benefits that may be available, and are typically used to pay out-of-pocket and non-covered expenses associated with the primary medical plan, and to help with additional expenses incurred while in the hospital.