Terms
A fixed amount of money that a patient with health insurance pays out-of-pocket for a covered healthcare service, like a doctor's visit or prescription, at the time of service; essentially, it's a set fee you pay as part of your cost-sharing with the insurance company.
What is a co-payment?
Provides Physical and emotional support to our pregnant members (includes prenatal services, childbirth, and up to three (3) months postpartum care)
What is a doula?
We pay 90% of the Plan Allowance (after the CYD if it applies)
What is an INN benefit?
We cover rental, up to the purchase price, or purchase (at our option), including necessary repair and adjustment, of durable medical equipment such as: • Wheelchairs • Hospital beds • Oxygen and equipment for its administration • Dialysis equipment
What is the DME Benefit?
Limited to 90 visits per calendar year when the attending physician or other healthcare professional: • Orders the care; • Identifies the specific professional skills required by the patient and the medical necessity for skilled services; and • Indicates the length of time the services are needed.
What are Home Health Services?
The amount you pay each year for most eligible medical services or medications before your health plan begins to share in the cost of covered services. For example, if you have to pay $600
What is the INN Deductible for Self Plus One and Self and Family?
We cover 100% of the plan allowance (no deductible)
What is the INN and overseas maternity benefit?
FSBP
What is the access code to Teladoc and Vhealth?
125 combined outpatient visits per calender year
What is physical, occupational, and speech therapy?
A hands-on treatment that uses pressure, rubbing, and manipulation of soft tissues in the body. It's a type of manual therapy that can help with relaxation, pain, and overall well-being.
What is the massage therapy benefit?
A medical appointment where a doctor performs tests and procedures to diagnose a health condition or illness
What is a diagnostic visit?
This list includes: limited to: • Voluntary sterilization • Surgically implanted contraceptives • Injectable contraceptive drugs (such as Depo Provera) • Intrauterine devices (IUDs) • Diaphragms
What is family planning?
Telehealth consultations for general medicine are available to members outside the 50 United States only through our telehealth vendor. Access general medicine telehealth services 24/7/365 by web or phone. Treatment may include preventive care and treatment for acute and chronic illnesses. A provider may also give referrals and prescribe
medications, when appropriate.
What is VHealth?
What are prosthetic devices?
Treatment typically involves manual therapy, often including spinal manipulation
What is a chiropratic treatment?
A medical procedure in which sperm is introduced into a woman's reproductive system to achieve pregnancy. It is used to treat infertility or when a woman chooses to conceive without a male partner.
What is AI (artificial insemination?
Medical treatments that help people conceive children. These services include medications, surgical procedures, and assisted reproductive technologies/therapies (ART).
What are infertility services?
Telehealth consultations are available to members in the 50 United States with primary care and specialty providers only through our telehealth vendors such as:• Doctors of Medicine (MD)• Doctors of Osteopathic Medicine (DO)• Nutritionists• Licensed Clinical Social Workers (LCSW)• Psychiatrists• Psychologists• DermatologistsTelehealth is available in all 50 United States.
What is Teladoc?
In-network, out-of-network, and providers outside the 50 United States: Nothing (No deductible) up to $500 per calendar year
What is the Orthopedic and prosthetic devices Benefit for wigs?
We cover 50 visits per person, per calendar year. We define chiropractic as the manipulation of the spine and extremities. Coverage: In-network (includes Guam): We cover up to the Plan maximum of $75 per visit and then all charges up to the Plan allowance. The member is responsible for all charges above 50 visits per person, per calendar year and all charges above the Plan allowance. (Note: For in-network chiro providers, we do not cover a full $75 per visit. The amount we cover is based on the contract/Plan allowance.) Out-of-network (includes Guam) and providers outside the 50 United States: We cover up to the Plan maximum of $75 per visit. The member is responsible for all charges above $75 per visit and/or 50 visits per person, per calendar year.
What is the Chiropractic benefit?
Birthing center and Walk In Clinic
What is a covered facility?
A virtual platform that provides comprehensive, on-demand support for women throughout their pregnancy journey, including access to healthcare professionals like OB-GYNs, lactation consultants, mental health specialists, and care advocates, all through a digital app, allowing for personalized guidance and support both during pregnancy and postpartum stages.
What is Maven?
Available to members residing or traveling outside the U.S. for behavioral health
What is Lyra ?
In-network, out-of-network, and providers outside the 50 United States: Nothing (No deductible) up to the Plan maximum of $4,000 per person or replacement per person every 3 consecutive calendar years and all charges after the Plan maximum
What is the adult hearing aid benefit?
Uses a holistic approach to help you and your covered dependents achieve your best health. Our LCC Health Coaches provide guidance, support, and resources for over 40 lifestyle and medical conditions to help you overcome obstacles that may be keeping you from realizing optimal health. You can talk to a health coach about health-related matters. - Lifestyle Coaching such as: • General health education • Prehypertension • Metabolic syndrome • Prediabetes • Weight management • Physical activity
What is the Lifestyle and condition coaching program?