Insurance plan which gives cash benefits to someone who has a covered accident.
An insurance professional who analyzes insurance rates, statistics and reserves.
Admitting a patient to a specific health facility for inpatient care.
A meeting between a medical practitioner and a senior discussing advance care planning including, living wills, powers of attorney and functions of health care proxies.
Documents which lay out decisions for end-of-life care to family, friends and doctors. The patient can also provide a living will and durable power of attorney.
Public support for a certain insurance proposal or insurance cause.
A law signed in March 2010 which aims to reduce health care costs, create more health care alternatives, increase accountability of insurance companies and increase overall health care quality.
A licensed representative who is permitted to sell insurance.
Insurance policy holder who receives a loan by transferring benefits from the policy to a lender.
Organization which purchases insurance for a group of people.
A common illegal process of medical institutions billing patients for services rendered even though the insurance company has reimbursed them already.
Chosen recipient of an insurance policy, property, trust or anything documented within a written will.
The monetary value policyholders receive from insurance companies after they induce a loss.
A drug that is sold and produced by a company, which holds a patent and trade name over the drug.
A designated insurance salesperson that generates quotes and policy options for clients.
Participants in a health plan that pay an annual fee to medical providers.
An insurance company that offers health insurance plans.
An efficient practice of supplying medical services to patients, to decrease costs and improve overall patient care.
A document an individual receives from an insurance company that specifies the active coverage the individual receives.
Made by a policyholder to an insurance company to pay for services rendered.
The form used when a person files an insurance claim.
Piece of legislation that allows employees to keep their health coverage for a period of time after they have left the company.
Part of a health plan which the policyholder splits the cost of healthcare with the carrier.
Insurance which covers a range of property, liability and workers’ compensation policies.
A claim made by a party in which there’s evidence of violation in policies, contract provisions or certain rules/statutes.
Health payment arrangements that can reduce the cost of health insurance.
The monetary amount that the injured party must pay on a medical bill.
Discount offered to a client who has valuable assets already insured, made by an insurance company.
Annual fee a policyholder pays in order for their insurance coverage to start.
A policy of health insurance companies to refuse a claim made by the insured party.
Insurance that covers a portion of costs integrated with dental care.
Person associated with the insured party who is financially intrusted.
Person in a family who generates income but relies financially on someone else within the family.
A program that grants discounts to people who visit certain providers, to save on health care costs.
Specific plans that offer varying discounts on medicine.
The date that an insurance policy begins.
An electronic system where health information is stored and retrieved.
Therapy services available for workers that have personal dilemmas which affect their day-to-day work.
Professionals who provide steps for health care programs to reduce costs and increase profits.
Programs that aim to decrease uninsured individuals by adding to the employer’s group health insurance system.
Program that grants tax credit to help employers purchase health insurance for employees.
Coinciding with employee benefit packages, health insurance is paid for by the employer.
Certain health plans and benefits which are provided by the company.
Offers of other health insurance providers which offer other qualified plans.
Certain health care or medical services which can’t be covered by an insurance policy.
Hardcopy explanation concerning a claim from the insurance company which states the amount paid by the company and the amount the client must pay.
Process to review a case if coverage is denied due to the determination it’s not medically necessary.
Payments to doctors or health care providers after certain services are performed.
The first step process to receive a decision on the utilization review appeal.
Pre-tax income can be used for any health care expenses with this savings account.
Comprehensive list of covered prescription drugs.
A drug that was once under patent by one company, can then be sold generically by any other drug company.
The right of consumers to receive reviews on certain decisions by their health plans.
All individuals within a group are covered by either an employer or other authority.
Coverage that is guaranteed to applicants no matter what, and will continue if the insured continues to pay the premium.
Insurance policy that will automatically be renewed if the policy holder pays the policy premium.
A service which helps people make improved choices in relation to health and medical care needs.
Federal agency established to overlook health plan benefit standards, operations of health insurance exchanges and supervision of individual affordability credits/subsidies.
A person who is responsible for overseeing health reform provisions. This person is appointed by the President.
Providing a variety of competing providers that offer different qualified plans.
Upon new employment, a person is able to receive comparable health insurance coverage.
Instead of paying for a service on an individual basis, people can choose to pay a monthly fee for services rendered.
Employer’s certain amount of money to spend on health care expenses for employees.
A savings account that uses tax-free income to help pay for health care expenses.
Health insurance coverage for people who have pre-existing medical conditions.
A plan with a specific deductible to an individual or family: $1,100 and $2,200 respectively.
Same health plan as a Fee For Service plan.
This policy is similar to an HMO, but IPA Policy holders can receive care in the own office of a physician.
Provision that helps individuals and families purchase health insurance coverage. Income can be upwards of four times the poverty level to apply.
Coverage that is solely for an individual.
A certain provision in which people are required to receive coverage up to certain standards, which were set coinciding with health insurance exchanges.
See Individual Affordability Credits.
Agreement between a health care professional and a health plan to provide medical services discounts and in return receive patient referrals.
Procedure where patients stay overnight in a hospital or medical facility.
The procedure to determine if an applicant is eligible for a health plan.
A provision that provides a variety of competing providers, with each providing different qualified plans, all up to standards set by the Health Choices Administration.
The length of time a person stays in a hospital or inpatient facility.
During a person’s lifetime, it’s the max. amount a health plan pays in benefits to the policy holder.
Certain amount of benefits paid for a covered expense.
Certain services on a policy are only covered for a certain amount of time.
If a person becomes disabled, it pays a certain percentage of their monthly earnings.
Any major or disastrous medical care is covered by major medical.
Plans that aim to provide care at reduced costs by partnering with providers and medical facilities.
The highest amount an insurance company pays for claims in a certain time period.
The highest amount an insurance company pays for claims and benefits during the insured’s life span.
Health insurance program that is sponsored by the government, providing low-income Americans with coverage.
Whether or not to accept an applicant for health coverage, insurance companies will sometimes use this process.
Health care coverage for Americans over 65 or with end-stage renal disease.
Medicare benefits that include prescription drug coverage, as well as Part A, and Part B coverage.
Insurance which cover certain costs that a Medicare plan does not cover.
When many employers in the same industry come together to purchase group health insurance at a lower cost to provide to their employees.
Policyholders are the sole owners of these insurance companies.
A collection of health care providers who provide insurance policy holders services at a lower rate.
Alternative cooperatives that offer networks of health care providers for medical services.
Insurers that approach policyholders by reimbursing them as well as physicians and hospitals, by using a managed care strategy.
Under a regular indemnity plan, these individuals can use out-of-plan providers and continue to have coverage for the services rendered.
Health care providers who don’t participate in a HMO or PPO. Some expenses may not be covered by out-of-network health professionals.
Highest amount of cost for health care a policy holder pays on their own annually.
Procedure in which a patient is not required to stay overnight in a hospital.
Health care providers that are under health plans to provide services and care to policy holders.
Health care reform legislation signed in March 2010 by the President, with the aim to provide coverage to uninsured Americans, lower health care costs and cut out pre-existing conditions as a prerequisite for denial of coverage.
A company which represents certain physicians and hospitals as agents.
Administration that oversees the daily activities of running and installing a health plan.
A plan that takes aspects of HMO and PPO plans, including choosing a Primary Care Physician and coverage either in or out-of-network providers.
Individual can enter a medical facility after being approved by a health care professional.
See Pre-Admission Certification.
Certain medical tests performed before admission to a hospital or health care facility.
Prior to admission for a surgery or hospital, approval must be met.
Conditions that occur before health care coverage begins.
A plan which includes coverage for in and out-of-network doctors as well as hospitals and other providers.
Monthly fee paid to the insurance company to have continued coverage.
Prescription drug coverage which can be added to original Medicare coverage.
Routine doctor’s visits that help prevent serious illness.
Physicians which are categorized as primary doctors for an individual or family.
Physicians who offer primary care to patients either by choice or assignment.
Health insurance plans that are sponsored by the private health insurance industry.
Formal complaint made against an insurance company, producer or insurance agency.
Health care professionals ranging from doctors to hospitals to specialists.
A public plan which would be a health benefit plan that competes with other plans that qualify as part of health insurance exchanges.
See Public Option.
Options for an insurance plan which can be run by an insurance company, agent or an automated system.
The amount of annual increase in premiums.
Argument that the government has to restrict care if health care were to be a public option.
In a geographic area, these standard fees are charged by health care practitioners.
When care of a patient is transferred to another clinic.
If an application has errors in their application, an insurer has the option to cancel that policy holder’s coverage.
Option of adding or excluding coverage on an insurance policy.
The probability of loss an insurance company takes on with the insured.
The amount a dental patient pays between the cost of service and allowance.
Programs used to identify a disease in its early stages.
Attaining another opinion from a second health professional after an initial opinion was given from the first professional.
Attaining another opinion from a second health professional after an initial opinion was given from the first professional on a possible surgical procedure.
A group health plan in which the organization provides the group health care directly to the employees, and not from an insurance provider.
An employee is out of work for a short period due to and injury or illness.
Insurance coverage that lasts anywhere from one month, to one year.
System where one person pays all fees and costs associated with their health care plan.
See Employer Tax Credits.
Groups that range from 1-99 employees.
A physician or health care professional that is trained in one branch of medicine.
Families with children who receive health insurance from the state, receive these matched funds benefits from the United States Department of Health and Human Services.
Certain state laws that are passed and must include specific benefits in health insurance plans.
Once the insured has paid all out-of-pocket expenses, insurance pay kicks in and begins to pay at full.
Health insurance coverage that can range from family policies, school-sponsored health plans, employer’s plan, or individual health insurance.
See Individual Subsidies.
coverage people can receive while traveling to another country.
A person who concludes the amount for premiums and issue policies.
Health insurance that covers an entire population.
Any necessary medical service or supplies needed for treatment are charged a common amount.
A review of current patients on efficiency, quality and cost-effectiveness.
Insurance which covers vision plans to help with co-pays or routine visits to optometrist or ophthalmologist.
Associated with specific health care costs, this is the time period a policy holder will not be insured.
If regular payments cannot be made due to an unforeseen disability, the insured can purchase this policy which waives the premium for a period of time.
Women with breast cancer and who elect to have breast reconstruction along with a mastectomy will have the right for coverage and protection.