Health Insurance Terminology
This is the most a member pays for covered services during the plan year.
What is the out-of-pocket maximum?
This is another word for dizziness or light-headedness.
What is vertigo?
This is the removal of all or part of the breast and usually performed to treat breast cancer.
What is a mastectomy?
This is the person or facility that delivers medical services. They also submit medical claims for services rendered.
Who is the Provider?
These are facilities and providers that are not in your insurer’s network. They might cost more and may not be covered by your plan.
What are out-of-network providers?
This is the fixed amount the member pays for covered services at the time care is provided.
What is the co-pay?
This means that the medication is available at any pharmacy without a prescription from a doctor.
What is over-the-counter (OTC)?
This term is the surgical removal of the appendix, a small tube that branches off the large intestine, to treat acute appendicitis.
What is an appendectomy?
This person is someone who is seeking care and can be referred to as the patient, individual, or employee.
Who is the member?
A condition is considered this when it is recurring and consistent.
What is chronic?
This is the regular payments made to keep your health care plan active.
What is the premium?
This is a test that is performed on urine, saliva, or other body substances to determine if a particular virus or bacteria is present in the body.
What is a culture?
This is the surgical removal of a woman's uterus.
What is a hysterectomy?
This entity is working to simplify the healthcare industry for its members.
Who is Collective Health?
This is a medical procedure that is performed to remove and test a small sample of tissue, skin, or other cells. It is often performed when cancer is suspected.
What is a biopsy?
This is the amount a member pays for covered services before insurance kicks in.
What is a deductible?
This is a pill that does not contain any active medications or ingredients.
What is a placebo.
This medication is used to treat certain kinds of bacterial infections. It is an antibiotic and It will not work for viral infections (such as common cold, flu)
What is Amoxicillin?
This entity is involved in paying medical claims and administering plan benefits, among other functions.
Who is the Health Insurance Company?
This is the authorization by your insurer for you to receive a service, treatment plan, prescription medication or durable medical equipment.
What is pre-authorization?
This is the percentage of charges a member owes for covered services.
What is co-insurance?
We say someone has this type of disease when it is is incurable or fatal.
What is terminal?
This is the surgical procedure to remove blockage from carotid arteries, the arteries located in the neck that supply blood to the brain.
What is a carotid endarterectomy?
This is the entity that offers healthcare coverage options to the employee base. They might also have a slew of health & wellness programs/perks that are packaged with a coverage plan.
Who is the employer or plan sponsor?
This medication is used to treat and prevent bronchospasm.
What is albuterol?