Health Insurance Glossary Terms Covering Reinsurance, Medicare, Preventive Care and More
Health Insurance Glossary Page 7
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Preventive Care. Medical care related to the prevention of illnesses rather than to their treatment; it may include vaccinations, screening tests, and routine yearly physicals.
Primary Care Physician. A provider in a managed care plan who is responsible for coordinating care and for approving medical tests or consultations with a specialist.
Procedure Code. A code given to a specific medical treatment, test, or procedure; it is used by insurers in processing claims.
Provider (Provider of Service). A doctor, hospital, or testing center that provides treatment or medical services.
Qualified Medicare Beneficiary Program. A program designed to help eligible Medicare beneficiaries pay for Medicare deductibles and other related expenses.
Reinsurance Program. A program that may be used by some self-funded plans to cover claims beyond a predetermined amount.
RESNA (Rehabilitation Engineering and Assistive Technology Society of North America). The agency that serves as the technical consultant for the Tech Act programs.
Reverse Mortgage. A mortgage that provides an individual home owner with monthly payments or a line of credit from a bank or mortgage company based on the equity in a house; the money may be used to provide for long-term health care or health insurance needs.
Rider. A provision added to a health insurance policy that may provide benefits for specific items that are not covered under the standard policy, including eyeglasses, hearing aids, or other medical services or equipment.
Secondary Benefits. See Coordination-of-Benefits.
Selected Low-Income Medicare Beneficiary Program. A program designed to help eligible Medicare beneficiaries pay for Medicare deductibles.
Self-funded Plan. A health benefit plan organized by a corporation for its employees, by a union or an association for its members, or by a state or municipal government agency.
Skilled Nursing Facility. A residential facility designed to provide skilled nursing care, often following a hospital stay.
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