Key healthcare terms
- This is the surface of the front teeth that faces the lip.
- This refers to a torn and ragged wound.
- A policy lapses and is terminated if the insured fails to pay the premium.
- For a spending account, this is the date when funds were most recently taken out of your account to pay expenses.
- This refers to you or your eligible dependent who enroll for coverage more than 31 days after the eligibility date. Late applicants may be subject to a waiting period.
- This refers to an obligation an individual or organization has for a specified amount or action.
- This is the maximum amount your plan will pay toward eligible expenses while you're covered under the plan.
Lifetime maximum benefit
- This is the total amount a health plan will pay, per covered member, for the lifetime of the coverage.
Lifetime orthodontic services
- The maximum amount payable (for each covered person) for eligible charges related to treatment, no further benefits are payable after this maximum is reached.
Limitation and exclusions
- Conditions listed in a policy for which benefits are not paid are limitations and exclusions.
- Limitations are items or services a health plan does not cover.
- The highest amount of money you can be charged for a covered service by doctors and other healthcare suppliers who do not accept Medicare assignment, the limiting charge only applies to certain medical services, not to medical supplies or equipment.
- The status of each line item in the claim can be paid, denied, or in process. Each line item may have a different status; however, if the entire claim is pending for review, each line item will indicate “in process.”
- The surface of the tooth toward the tongue is the lingual surface.
- This type of anesthesia, such as Novocaine, eliminates sensation, especially pain, in a part of the body by topical application or injection of a drug.
- If you have a Medicare Advantage and prescription drug plan, you are "locked-in," which means (unless you qualify for special circumstances) you can only switch plans during certain times of the year. The lock-in period runs from April 1 to November 14.
Long-term care hospital
- A hospital that has an average inpatient length of stay of greater than 25 days is a long-term care hospital.
- These proceeds are paid to beneficiaries all at once instead of in installments.