| Premium | | the cost of the plan is deducted from the employees wages before taxes to allow employees to pay for medical expenses and childcare |
| Medicare | | monthly fee for insurance |
| Medicaid | | a physical or mental condition that existed before the insurance policy was issued |
| Indigent | | people who are covered under the managed care plan |
| Managed Care | | a tax shelter set up for the purpose of paying medical bills when the person has a high deductible low cost insurance plan |
| Group plan | | AKA indemnity plan- the patient can go to any provider or hospital and bills are sent to the carrier and the patient is reimbursed according to plan rules |
| Indemnity | | charges that are proper and meet the standards of good medical practice in the local area |
| HIPPA | | the money the patient pays up front each year towards their medical expenses before the insurance company pays |
| Copay | | the amount you pay when you see physician if you have managed care |
| PAR | | law enacted in 1996 that requires group plans to accept transfers from other plans without imposing a preexisting condition clause |
| NonPAR | | the amount the patient pays when they meed their deductible and share the bill with the insurance company |
| Coinsurance | | has no contractual agreement with the insurance provider |
| preexisting condition | | the patient can go to any participating physician within the plan without having a referral from a primary care physician |
| UCR | | insurance for low income and certain disabled individuals |
| Deductible | | When a certain amount has been paid by the patient each year, the insurance company then pays the full UCR benefits |
| Our-of-pocket maximum | | poor or low-income individuals |
| CMS 1500 | | an insurance policy that covers a group of people |
| Enrollees | | contracts with third party payer and agrees to abide by rules and regulations of that carrier |
| Policy Holders | | the insured person |
| FSA | | The patient has a primary care physician who directs their care within the plan |
| MSA | | insurance for elderly and certain other disabled individuals |
| Medical Necessity | | traditional health care policy where patients can choose any provider they wish. |
| Fee-for-service | | medical care established by a corporation established under state and federal laws |
| HMO | | the standard insurance form |
| PPO | | the part of the provider's charge that the insurance carrier allows as a covered expense |
| policy | | a written agreement between two parties whereby one entity agrees to pay a specific amount to the second entity if certain undesirable events occur |
