Alphabetized by English term.
A - C
| English | Spanish | Description |
|---|---|---|
| Annual maximum | Máximo anual | Most insurance pays per year |
| Benefits | Beneficios | What the plan covers |
| Carrier / Payer | Aseguradora | Company providing insurance (Aetna, Cigna, etc) |
| Category of service | Categoría de servicio | Preventive / Basic / Major / Ortho / Cosmetic |
| Coinsurance | Coinsurance | % patient pays after deductible |
| Copay / Copayment | Copay | Fixed amount per service (common in HMO) |
| Coverage | Cobertura | Benefits included in plan |
D - F
| English | Spanish | Description |
|---|---|---|
| Deductible | Deducible | What patient pays before insurance starts |
| Dependent | Dependiente | Family member of subscriber with coverage |
| Discount Dental Plan (DPP) | Plan de descuento | NOT insurance — patient pays monthly fee for discounts |
| Effective date | Fecha de vigencia | Date plan becomes active |
| EOB | EOB | Explanation of Benefits — detail of how insurance paid a claim |
| Family deductible | Deducible familiar | Max combined deductible for family |
| Frequency limit | Límite de frecuencia | How often a procedure can repeat |
G - M
| English | Spanish | Description |
|---|---|---|
| Group Number | Número de grupo | Identifies specific plan within carrier (e.g. 303303) |
| HMO | HMO | Closed-network plan with primary dentist |
| Indemnity | Indemnity | Traditional plan, no network, pays % of UCR |
| In-network | En la red | Dentist contracted with insurance |
| Lifetime maximum | Máximo vitalicio | Most paid in lifetime (orthodontics) |
| Medicaid | Medicaid | State plan for low income |
| Medicare | Medicare | Federal plan for 65+ |
| Medicare Advantage / Part C | Medicare Advantage | Medicare administered by private insurer |
| Member ID / Subscriber ID | Member ID | Patient's ID in plan |
N - P
| English | Spanish | Description |
|---|---|---|
| Network | Red | Set of contracted providers |
| Out-of-network (OON) | Fuera de red | Dentist not contracted with insurance |
| Plan Variant | Plan Variant | Atypical rules or frequencies within a plan |
| PPO | PPO | Flexible plan with in-network and OON benefits |
| Predetermination | Predeterminación | Estimate submitted to insurance to confirm coverage |
S - U
| English | Spanish | Description |
|---|---|---|
| Subscriber | Suscriptor | Plan holder (the employee) |
| UCR | UCR | Usual, Customary & Reasonable — standard market fee |
| Waiting period | Período de espera | Time from effective date before a service is covered |