The maximum charge accepted by a health plan for a specific covered medical service or supply.

The amount of covered expenses you must pay in a plan year before your insurance plan pays any benefits.

An arrangement by which you request that your health benefit payments be made directly to a designated person or facility, such as a doctor or hospital.

The licensed doctor who has primary responsibility for your medical care and treatment.

Any health service that does not require an overnight hospital stay.

The determination that the requested treatment is medically necessary, delivered in the appropriate setting, a TRICARE benefit, and that the treatment will be cost-shared by the Department of Defense.

The fee Medicare sets as reasonable for a covered medical service or item. This is the amount Medicare pays for a service or item. The amount may be less than the actual amount charged by a doctor or supplier. The approved amount is sometimes called the approved charge.

The maximum amount a benefits plan will pay for a procedure.

Radiology tests that use complex, highly developed, non-invasive technology to view the interior of the body. Examples include CT scans, ultrasound, MRA and MRI tests.

Services received in support of your medical care, such as laboratory work, X-rays and anesthesia.