Glossary of Terms
Affordable Care Act: The Patient Protection and Affordable Care Act (ACA) is a federal law passed in 2010 that aimed to reform the U.S. health care system. The purpose of the law is to expand access to high-quality affordable health insurance. In California, this includes the creation of a new health insurance marketplace, called Covered California, as well as the expansion of California’s free public health insurance program, Medi-Cal.
Application Assistor: An individual trained and certified to enroll eligible individuals in Healthy San Francisco. HSF Application Assistors also provide application assistance for other programs, such as Medi-Cal and Healthy Kids HMO.
Covered California: Covered California is the marketplace that connects Californians to accessible, high-quality health coverage.
Federal Poverty Level: A measure of income level issued annually by the Department of Health and Human Services. Federal poverty levels are used to determine your eligibility for certain programs and benefits.
Health Access Program: A program designed to make health care services accessible and affordable for an uninsured population. It is not a health insurance product, but can provide services such as primary care and preventive care, prescription drugs, and specialty care; certain restrictions apply depending on the service and the program.
Health Care Reform: (also known as Affordable Care Act) Enacted in March 2010, the federal Patient Protection and Affordable Care Act, commonly referred to as “Obamacare,” provides the framework, policies, regulations and guidelines for implementation of comprehensive health care reform by the states. The Affordable Care Act will expand access to high-quality affordable insurance and health care.
Health Insurance: A contract that requires your health insurer to pay some or all of your health care costs in exchange for a premium.
Healthy San Francisco: A health access coverage program created by the City and County of San Francisco that makes health care services accessible and affordable for eligible, uninsured residents.
Healthy San Francisco Enrollment Site: The location in San Francisco where a Healthy San Francisco Participant will meet with a Certified Application Assistor (CAA) to complete an HSF application. For most Participants, the enrollment site is the HSF Medical Home where they will receive health care services.
ID Card: A card that you should carry with you at all times in order to receive medical care. It lets your Medical Home know that you are enrolled in Healthy San Francisco.
Medi-Cal: California’s Medicaid health care program. This program provides free medical services for children and adults with limited income and resources. Your local County Welfare/Social Services Department manages Medi-Cal eligibility determinations. You can get Medi-Cal as long as you meet the eligibility requirements.
Medical Home: The facility (in most cases, a clinic) where a Healthy San Francisco Participant receives health care services.
Participant Fees: Depending on your income, you may be required to pay a Participant Fee for the Healthy San Francisco program, which is paid four times a year. The amount you pay depends on your household income, or your Federal Poverty Level (FPL).
Point of Service Fees: A fee you pay for medical services at the time you receive them. For example, you may need to pay a fee each time you visit the doctor, go to the emergency room, or have a prescription filled.
San Francisco Department of Public Health: The department is a government entity run by the City of San Francisco. It strives to achieve its mission through the work of two Divisions – the Community Health Network (CHN) and Population Health and Prevention. The CHN is the City’s health system and has locations throughout the City including San Francisco General Hospital Medical Center, Laguna Honda Hospital and Rehabilitation Center, and over 15 primary care health centers. The Population Health and Prevention Division has a broad focus on the communities of San Francisco and is comprised of the Community Health and Safety Branch, Community Health Promotion and Prevention Branch, and the Community Health Services Branch.
SF City Option Program: The SF City Option Program is one option for Employers to satisfy the Employer Spending Requirement of the San Francisco Health Care Security Ordinance (HCSO). For more information about the City Option Program, visit www.sfcityoption.org.