Common words

Insurance for serious medical conditions; pays a lump sum if diagnosed with covered illnesses like cancer, heart attack, or stroke. Helps ease financial stress during recovery.

A benefit package is a set of additional perks and rewards provided by employers to employees alongside their regular pay. It aims to attract and retain talent, boost employee well-being, and includes benefits like health insurance, retirement plans, paid time off, and more.

HMO stands for Health Maintenance Organization. It is a managed care health insurance plan that provides comprehensive medical services through a network of healthcare providers. Members must use in-network providers and typically need a primary care physician for coordination of care. HMOs emphasize preventive care and have low or no deductibles with fixed copayments.

stands for Preferred Provider Organization. It is a flexible health insurance plan that allows members to use both in-network and out-of-network providers. While in-network services offer lower costs, members have the freedom to see specialists without referrals and get partial coverage for out-of-network care.

Short Term Disability (STD) is a type of insurance that provides temporary income replacement to employees unable to work due to covered illnesses or injuries. It typically covers a few weeks to several months, offering a percentage of the employee's regular salary during the disability period. STD is often part of an employer's benefits package and requires medical certification for the claim.

 Term Life Insurance provides coverage for a specific term (e.g., 10 or 20 years). It pays a death benefit if the insured passes away during the term, but it has no cash value or investment component. It offers affordable premiums and is ideal for temporary needs or budget-conscious individuals.

Is an insurance system that provides benefits to employees who are injured or become ill at work. It covers medical treatment, lost wages, and rehabilitation. It's a no-fault system, meaning employees are compensated regardless of fault. Each country or state has its own laws and regulations for Workers' Comp.

 Is when an employee takes time off from work for personal reasons, like health issues, family emergencies, or maternity/paternity leave. It often provides job protection and may come with specific benefits depending on company policies and applicable laws.

 Is an organization or company that provides health insurance coverage to individuals or groups, managing and administering health insurance plans and paying for covered medical services. Examples include health insurance companies, HMOs, PPOs, and government health insurance programs.

 Are requests made by policyholders to their insurance company for coverage or compensation following a loss or damage covered under their policy. Policyholders report the incident, provide documentation, and the insurance company investigates and either approves or denies the claim, providing compensation if approved. 

Is a specific period when individuals can enroll in or change their health insurance and benefits plans. It happens once a year and allows people to make decisions about their coverage for the upcoming year.

 Is a healthcare reform law in the United States that aimed to increase access to affordable health insurance, expand Medicaid, protect individuals with pre-existing conditions, and provide essential health benefits. It also established Health Insurance Marketplaces for people to shop for coverage.

Stands for Employee Assistance Program. It's a workplace benefit that provides confidential counseling and support for employees facing personal or work-related challenges, such as stress, mental health issues, substance abuse, and work-life balance.

Are additional benefits offered by employers or organizations to employees or members beyond their basic salary. These may include health benefits, retirement plans, flexible work arrangements, training opportunities, gym memberships, childcare assistance, and more. Perks aim to enhance job satisfaction and attract talent.

Replaces a portion of income for people unable to work due to a prolonged illness or disability. It provides financial security during extended periods of inability to work.

Also known as flexible benefits plans, allow employees to choose from a range of benefits and customize their compensation package to fit their individual needs. They offer flexibility and personalized options for employees to select benefits that suit them best.

Are additional perks offered by employers to employees, beyond salary. Examples include health insurance, retirement plans, paid time off, flexible work arrangements, and other non-monetary benefits aimed at enhancing employee well-being and satisfaction.

Is the amount of money an individual must pay out of pocket before their insurance coverage starts to pay for certain expenses. It is a common feature in insurance policies and helps manage risk and lower premiums.

Is the amount of money an individual must pay out of pocket before their insurance coverage starts to pay for certain expenses. It is a common feature in insurance policies and helps manage risk and lower premiums.

Can vary based on the health insurance plan and the type of service or treatment received. It is essential for policyholders to understand their coinsurance obligations and review their insurance policy to know how much they will be responsible for paying for different types of medical services.

Is a fixed amount that individuals pay for covered medical services or prescription drugs at the time of service. The insurance company covers the remaining cost after the copayment is made.

Is when the insured person and the insurance company split healthcare expenses. It involves deductibles, copayments, coinsurance, and out-of-pocket maximums to manage costs and encourage responsible healthcare usage.

Occurs when a healthcare provider bills a patient for the difference between their charges and the amount covered by the patient's insurance. It often happens with out-of-network providers and can lead to unexpected medical costs for the patient. Some states have regulations to protect patients from excessive balance billing.

Are medical treatments or procedures that a health insurance plan does not cover. Examples include cosmetic procedures, experimental treatments, certain dental and vision services, infertility treatments, and alternative medicine. Patients are responsible for paying the full cost of these services out of pocket.

 Is a list of prescription drugs covered by a health insurance plan or pharmacy benefit manager. It categorizes medications into tiers based on cost and coverage, helping patients and providers understand which drugs are available and at what cost.

Includes screenings, vaccinations, check-ups, and counseling aimed at detecting and preventing health issues before they worsen. It helps maintain good health and reduces the risk of future health problems.

Refers to the amount of money an individual or entity pays to an insurance company in exchange for coverage under an insurance policy. This payment is usually made on a regular basis, such as monthly or annually, and it ensures that the insurance policy remains active and provides the specified benefits. The premium amount can vary based on factors such as the type of insurance (health, auto, home, etc.), the coverage level, the insured person's age and health status, and other relevant considerations.

Is a healthcare professional, facility, or organization that offers medical services to patients. This includes doctors, hospitals, clinics, specialists, and other healthcare professionals. They play a crucial role in delivering medical care and services.

Restores function and appearance to body parts affected by injury, disease, or congenital conditions. It aims to improve quality of life, especially after trauma, cancer, or birth defects. Unlike cosmetic surgery, it focuses on both form and function.

 Aid in recovering physical, mental, or cognitive function after illness, injury, or surgery. They include physical therapy, occupational therapy, speech therapy, and more. The goal is to restore independence and enhance daily life.

 Aid in recovering physical, mental, or cognitive function after illness, injury, or surgery. They include physical therapy, occupational therapy, speech therapy, and more. The goal is to restore independence and enhance daily life.

Centers provide immediate medical attention for minor injuries and illnesses that aren't life-threatening. They offer convenient walk-in services with extended hours, making them a cost-effective alternative to the emergency room for non-severe conditions.

Is a recommendation made by a healthcare provider for a patient to see another healthcare professional or specialist for further evaluation, diagnosis, or treatment of a specific condition or concern. Referrals are often made when the primary healthcare provider believes that the expertise of a specialist is needed to address a particular medical issue. Referrals help ensure that patients receive the most appropriate and specialized care for their specific health needs.

Refers to specialized medical care provided by licensed nurses and healthcare professionals in a clinical setting. This type of care is often necessary for patients who have complex medical needs, require ongoing monitoring, or are recovering from surgeries, illnesses, or injuries. Skilled nursing care involves a higher level of medical expertise and is provided under the guidance of a physician's orders. It can include services like wound care, medication administration, rehabilitation, and more.

Is a type of medication that is used to treat complex or rare medical conditions, often requiring special handling, administration, monitoring, or patient support. These drugs are typically designed for conditions such as cancer, multiple sclerosis, rheumatoid arthritis, and other chronic or severe illnesses. Specialty drugs are often high-cost, may have specific storage or administration requirements, and often necessitate close coordination between healthcare providers, pharmacists, and patients to ensure safe and effective use.

Refers to a method that health insurance companies use to determine the maximum amount they will reimburse for a specific medical service or procedure. UCR rates help insurers establish a standard fee that is considered appropriate and reasonable for a particular healthcare service in a specific geographic area. This can influence how much the insurance company covers, and the patient may be responsible for paying any amount exceeding the UCR rate.