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Medical Insurance: Chapter 1 - Glossary

Benefits - what is specified as "covered" by the insurance administrator, or other services provided by the employer.

Claims - that act of "claiming" the need for payment, or reimbursement of payment, for services rendered.

Coinsurance - a percentage of the cost that must be paid by the policy holder for treatment.

Co-pay - a specified amount that must be paid by the policy holder at the time of treatment.

Deductible - an amount specified by the insurance plan that the policy holder must pay prior to the insurance administrator/employer contributing to payments.

ERISA - a federal government law, Employee Retirement Income Security Act of 1974, which sets standards of how insurance in the private sector must be managed.

ID Card - a card issued by your insurance administrator to present as evidence of having insurance coverage.

Insurance Administrators - companies and individuals whose responsibilities are to make the process of insurance coverage work.

Medical Insurance - insurance coverage for medical treatment.

Medigap - a separate government sponsored program for eligible individuals that provides the ability to purchase insurance to cover the difference between what the government pays for medication and the actual purchase price of the medication.

Medicaid - a government sponsored program that provides medical coverage for low-income households and/or their dependents.

Medicare - a government sponsored program of medical coverage for age-eligible individuals, or special conditions for non-age-eligible individuals.

Pre-Existing Condition - any recent or on-going disease or injury requiring supervision by a doctor.

Superbill - a form used in many doctors' offices that specifies the treatment received during an office visit.

Underwriting - guaranteeing payment by the insurance administrator.

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