Health Insurance and Health Care Glossary of Terms

Health Insurance Glossary Page 1

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Assisted Living Facility. A residential facility designed to provide a range of supportive services -- including meals, housekeeping, and medical services -- for senior citizens.

Balance Bill. The difference between the provider's bill and the amount of reimbursement offered by the insurance company.

Basic Benefits. The provision in a traditional health insurance policy that provides coverage for specific medical tests, ambulance service, and other services.

CHAMPUS (Civilian Health and Medical Program of the Uniformed Services). A health benefits system for eligible dependents of armed services personnel and for eligible retired armed services personnel.

Claim Appeal. A request that an insurer review a specific claim and the level of reimbursement.

COBRA (Congressional Omnibus Budget Reconciliation Act). A set of federal regulations designed to allow for a temporary continuation of health insurance benefits for eligible individuals.

Co-insurance. The percentage of a medical bill that an individual is obligated to pay, according to the policy.

Conversion Option. A provision contained in some group health insurance plans that permits a person to convert a group policy to an individual policy, thus allowing for additional benefits when the lifetime benefit maximum has been reached.

Coordination-of-Benefits. A system for providing secondary benefits in a situation in which an individual is covered under more than one health insurance plan.

Co-payment. See Co-insurance.

Day Care Program. A specialized, non-residential program for senior citizens that offers a range of recreational and medical services.

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