- Industry: Insurance
- Number of terms: 2862
- Number of blossaries: 0
- Company Profile:
Aetna, Inc. is an American diversified health insurance company, providing a range of traditional and consumer directed health care insurance products and related services, including medical, pharmaceutical, dental, behavioral health, group life, long-term care, and disability plans, and medical ...
These rules are used to decide which plan pays first for people who have more than one plan. This helps coordinate coverage and allows claim information to be shared by the plans. This way, the plans can avoid duplicate payments.
Industry:Health care
These are benefits a state requires in a policy. If the benefit is not in the policy, it cannot be sold in the state.
Industry:Health care
Some procedures can be done in a hospital, surgery centre or doctor’s office. The person gets it done and goes home. There is no overnight stay. This is also called “ambulatory surgery.”
Industry:Health care
This is the dollar amount you pay for health care expenses. In most plans, you pay this after you meet your deductible limit. For example, you pay a set dollar amount to your doctor for an office visit. So, if your copay is $25, you pay that amount when you go to your doctor. Copays are also used for some hospital outpatient care services in the Original Medicare plan. In prescription drug plans, it is the amount you pay for covered drugs.
Industry:Health care
This is a way that a health plan controls drug costs. It means a person must try certain drugs before a particular brand-name drug will be paid for by the plan. The first drugs are often generic and cost less.
Industry:Health care
This is care given for immediate pain relief. It is not a final treatment for a condition.
Industry:Health care
This protects employers who take on most of the risk of a health plan. An employer can buy this to avoid having to pay for large health claims. If health care costs go over the amount listed in the contract, the plan will pay the rest.
Industry:Health care
This is when a person has an illness or injury. It stops the person from doing one or more job tasks. This causes the person to earn 80 percent or less of income earned before he or she became disabled.
Industry:Health care
This is an optional benefit. It goes with some long-term disability plans. It raises the monthly benefit amount each year. The person on disability gets more money based on the cost of living. These raises are given only for a set time period.
Industry:Health care
This is a person who signs up for a health plan. If the plan is a family health plan, the person can add people to it as dependents. Those people must be eligible to be added. Some health plans also use the word “enrollee” for this term.
Industry:Health care