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Definitions (83)
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alternative medicine
some medical techniques once considered outside the boundaries of standard practice have become more accepted in recent years and may now be eligible for coverage. Acupuncture, midwives, and osteopath [..]
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annual limits
are maximums on the dollar amounts the plan will pay for any given year
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approved charge
the dollar amount on which your insurer bases its payments and your co-payments.
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assignments of benefits
the insured allows a hospital or doctor to collect your health insurance benefits directly from your insurance company.
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associated group plans
fully insured plans issued to employee groups, including those formed by labor unions, nonprofit membership corporations, etc.
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beneficiary
the recipient of the benefits of the policy
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benefit maximum
the most a policy pays for a specified loss or covered service. This can be expressed as either a period of time, a dollar amount, or a percentage of the approved amount.
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benefit period
the time period for which payments for benefits of an insurance policy are available.
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capitation to providers
a system where an HMO pays a doctor or hospital a flat monthly fee for the care of each health plan member, whether or not any services are delivered.
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chronic condition
prolonged conditions or illness, such as asthma, diabetes, etc.
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