This is a card given to each person covered under a benefit plan.
In-area refers to healthcare providers and services that are available to members within the geographic area that a specific health plan services.
These are providers who have contracts with a benefit plan to provide services at a set rate.
Indicates an estimate or a claim has been received but processing is not complete.
This refers to an application in which one or more of the required elements established by CMS are not complete. For example: the form isn't signed by the beneficiary or the legal representative, supporting documentation for a representative's signature isn't included, necessary elements on the form are not completed, or entitlement to Part A cannot be established.
Incurred claims equal the claims paid during the policy year plus claim reserves.
This traditional fee-for-service coverage allows providers to be paid according to their service fees.
The amount Humana pays toward the cost of a covered prescription drug is known as individual allowance.
Amount of eligible expense a covered person must pay each year before the dental plan will pay for eligible benefits.
Coverage for which premiums are being paid or for which premiums have been fully paid is referred to as in-force business.
Initial Coverage Election Period
ICEP is the three-month span immediately before you are entitled to Medicare Part A and enrolled in Part B. During this time you can choose a Medicare health plan.
Initial Enrollment Period (IEP)
The first chance you have to enroll in Part B is during your IEP, a seven-month period that begins three months before the month you are first eligible for Medicare Part B. Usually, this means the IEP begins three months before the month in which you turn 65 years old. It ends three months after you turn 65. The Initial Enrollment Period is different from the Initial Coverage Election Period. See definitions for Eligibility: Medicare Part A and Initial Coverage Election Period.
In-network coverage refers to the eligible benefits that are offered when you choose an in-network or participating provider.
A healthcare provider (such as a doctor, hospital, other medical facility, or pharmacy) is considered an in-network provider if it has agreed to charge a set rate for members of a health benefits plan. Your network choices may vary, depending on your plan and where you live. With PPO and HMO plans, you can reduce your costs by using in-network providers, which are also known as participating providers.
You are considered an inpatient if you have been registered and admitted to a healthcare facility and have been charged for room and board.
Healthcare you receive while admitted to a hospital is inpatient care.
An inpatient hospital admits patients and primarily provides the following services by or under the supervision of physicians: diagnostic services, surgical and non-surgical therapeutic services, and rehabilitation services. Psychiatric facilities, even if they admit patients, are not considered inpatient hospitals.
Inpatient hospital services
These services include bed and board, nursing services, diagnostic or therapeutic services, and medical or surgical services.
This refers to someone covered by an insurance benefits plan.
An insurer is an organization that bears the financial risk for services and material provided to an individual or group.