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surplus

English translation: proportion of medical expenses corresponding to surplus income (health insurance)

GLOSSARY ENTRY (DERIVED FROM QUESTION BELOW)
English term or phrase:surplus
Selected answer:proportion of medical expenses corresponding to surplus income (health insurance)
Entered by: Charles Davis

09:46 Apr 19, 2012
English language (monolingual) [PRO]
Bus/Financial - Insurance
English term or phrase: surplus
"I understand that as a condition of AAA eligibility, BBB or the CCC may determine that I am responsible for a monthly share of cost payment (spend down/surplus)."

I have no idea about the meaning of surplus in this context.
Thank you in advance.
boostrer
United States
Local time: 01:47
proportion of medical expenses corresponding to surplus income (health insurance)
Explanation:
The key to this is "spend down". This indicates that the context is health insurance; in fact I am sure it refers specifically to a well-known US health insurance scheme, but I will not give the name because you have chosen to conceal it.

In order to be eligible for medical insurance cover, your income or assets (wealth) must not be higher than a certain level, because the scheme is designed for poor people. However, if you are above that level, you may still be able to get cover. The way this is done is called "spend down" or "surplus" (in this case, the bar indicates that they are alternative names for the same thing).

The idea is that if your income or assets are above the maximum level you offset the excess against medical expenses: in other words, the insurance scheme does not cover 100% of your medical costs, as it does for poorer people below the limit; instead, it covers only part of the costs, and you pay a proportion corresponding to the surplus: the degree to which you are above the limit. It is called "spend down" because you "spend down" to the limit; you spend part of the costs to bring yourself down to the limit for cover:

"The spend-down program (also called excess or surplus income) is a way for certain categories of applicants to get XXX [name of health insurance scheme] even though their income or assets are over the limit, by offsetting their excess with medical expenses. For example, imagine two potential XXX applicants (who we will assume both are in the DAB category and both have assets below the limit).

Sam has income of $700/mo., and is therefore fully eligible for XXX ($700 is less than $792).

Pam has income of $900/mo., but also spends $140/mo. on medical supplies and doctor's visits. She would ordinarily not be eligible for XXX, because her income is over the limit by $88/mo. (XXX "disregards" the first $20 of income for people in the DAB category[...]). However, she can "spend-down" her excess income to the XXX level by using the $ 88/mo. of medical expenses. Once she shows XXX that he has $ 88/mo. of medical expenses in a given month, then [her] XXX coverage will be activated for the rest of that month. It is almost like a monthly deductible."
http://wnylc.com/health/entry/46/

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Note added at 4 hrs (2012-04-19 14:10:05 GMT)
--------------------------------------------------

So "surplus" here means an amount in excess of a limit: the excess income of the insured person and the corresponding excess amount that the insured must pay beyond the amount covered by the insurance.

Selected response from:

Charles Davis
Spain
Local time: 07:47
Grading comment
Thank you!
4 KudoZ points were awarded for this answer



SUMMARY OF ALL EXPLANATIONS PROVIDED
4proportion of medical expenses corresponding to surplus income (health insurance)
Charles Davis
3sobrecosto
Patricia ONeill
3additional cost
Vesna KK


  

Answers


8 mins   confidence: Answerer confidence 3/5Answerer confidence 3/5
sobrecosto


Explanation:
El cambio implicaría un aumento en la prima o valor a pagar.

--------------------------------------------------
Note added at 22 mins (2012-04-19 10:08:37 GMT)
--------------------------------------------------

The change would imply an increase in the premium value, i.e. what is to be payed.
Surplus would be an extra cost.

Patricia ONeill
Local time: 02:47
Specializes in field
Native speaker of: Native in SpanishSpanish
Notes to answerer
Asker: Thank you, but I don't know Spanish - к сожалению... דא עקא...

Asker: Thank you for your time. However, I have to choose the answer of Charles.

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40 mins   confidence: Answerer confidence 3/5Answerer confidence 3/5
additional cost


Explanation:
I guess.

Vesna KK
Finland
Local time: 08:47
Works in field
Native speaker of: Native in BosnianBosnian, Native in SerbianSerbian
Notes to answerer
Asker: Thank you for your time. However, I have to choose the answer of Charles.

Login to enter a peer comment (or grade)

2 hrs   confidence: Answerer confidence 4/5Answerer confidence 4/5
proportion of medical expenses corresponding to surplus income (health insurance)


Explanation:
The key to this is "spend down". This indicates that the context is health insurance; in fact I am sure it refers specifically to a well-known US health insurance scheme, but I will not give the name because you have chosen to conceal it.

In order to be eligible for medical insurance cover, your income or assets (wealth) must not be higher than a certain level, because the scheme is designed for poor people. However, if you are above that level, you may still be able to get cover. The way this is done is called "spend down" or "surplus" (in this case, the bar indicates that they are alternative names for the same thing).

The idea is that if your income or assets are above the maximum level you offset the excess against medical expenses: in other words, the insurance scheme does not cover 100% of your medical costs, as it does for poorer people below the limit; instead, it covers only part of the costs, and you pay a proportion corresponding to the surplus: the degree to which you are above the limit. It is called "spend down" because you "spend down" to the limit; you spend part of the costs to bring yourself down to the limit for cover:

"The spend-down program (also called excess or surplus income) is a way for certain categories of applicants to get XXX [name of health insurance scheme] even though their income or assets are over the limit, by offsetting their excess with medical expenses. For example, imagine two potential XXX applicants (who we will assume both are in the DAB category and both have assets below the limit).

Sam has income of $700/mo., and is therefore fully eligible for XXX ($700 is less than $792).

Pam has income of $900/mo., but also spends $140/mo. on medical supplies and doctor's visits. She would ordinarily not be eligible for XXX, because her income is over the limit by $88/mo. (XXX "disregards" the first $20 of income for people in the DAB category[...]). However, she can "spend-down" her excess income to the XXX level by using the $ 88/mo. of medical expenses. Once she shows XXX that he has $ 88/mo. of medical expenses in a given month, then [her] XXX coverage will be activated for the rest of that month. It is almost like a monthly deductible."
http://wnylc.com/health/entry/46/

--------------------------------------------------
Note added at 4 hrs (2012-04-19 14:10:05 GMT)
--------------------------------------------------

So "surplus" here means an amount in excess of a limit: the excess income of the insured person and the corresponding excess amount that the insured must pay beyond the amount covered by the insurance.



Charles Davis
Spain
Local time: 07:47
Native speaker of: English
PRO pts in category: 12
Grading comment
Thank you!
Notes to answerer
Asker: Thank you a lot! Your explanation sound very convincing - and I don't have to invent any new meanings of surplus. It fits the context perfectly. You are also right about the US insurance. It is not something secret or confidential, but I have a habit of concealing names in proz questions.

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