Crossword Clinic: Decoding Health Insurance Jargon

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Across
  1. 3. A fixed small amount you pay for a healthcare service or prescription, usually at the time of the visit.
  2. 5. People enrolled under a health insurance policy who receive benefits, including the subscriber and their family members(dependents).
  3. 7. A health problem that existed before you got your insurance policy.
  4. 9. The organization or person who pays for healthcare services, like an insurance company or government program.
  5. 10. A waiting time before you can make changes to or cancel a policy after purchasing it. During this period, no health services expenses are covered by the insurance.
  6. 13. Medical or personal care services provided in a person's home rather than in a hospital or clinic.
  7. 16. The date when an insurance policy or coverage starts.
  8. 19. Medical care provided when a patient stays overnight in a hospital for more than 24 hours.
  9. 21. The time during which your insurance policy provides benefits and protection. It starts from the policy effective date to the policy term date.
  10. 25. A type of facility that provides medical care, rehabilitation, and assistance with daily activities for people recovering after surgery or illness.
  11. 28. The amount you pay for your health insurance plan, usually on a monthly, quarterly, half-yearly, or yearly basis.
  12. 29. The date when an insurance policy or coverage ends.
  13. 30. A doctor who focuses on a specific area of medicine, like cardiology or dermatology.
Down
  1. 1. In health insurance, this is the time you must wait after your policy starts before getting coverage for pre-existing conditions, as decided by the insurance company.
  2. 2. A facility or care designed to provide comfort and support for people who are terminally ill and not expected to recover.
  3. 4. A person receiving medical care or treatment.
  4. 6. A U.S. law that protects the privacy of your health information and ensures it's kept confidential.
  5. 8. Health conditions that developed after the start of your insurance coverage and are covered by your policy. It can be anything (any illness/disease/injury).
  6. 11. Medical care or procedures that do not require an overnight stay in a hospital or not getting services for more than 24 hours.
  7. 12. A person who is visiting a healthcare provider for the first time or has not been seen by the provider for more than 36 months.
  8. 14. The small percentage of costs you pay for a healthcare service after meeting your deductible, where the payment is split between the insurance company and the patient, with the patient paying a smaller ratio.
  9. 15. A person or organization that provides medical services, such as doctors or hospitals. In healthcare, individuals such as Primary Care Physicians, nurse practitioners, physician assistants, and specialists, as well as facilities like hospitals and clinics, skilled nursing facilities, hospices, and home health are collectively called this.
  10. 17. What do you call a patient who has been seen by a healthcare provider within 36 months of their last visit, but would be classified as a new patient if more than 36 months have passed since the previous visit?
  11. 18. Healthcare services that are included in your insurance plan and promised that will be paid for by the insurer.
  12. 20. A person (such as a child or spouse or anyone from the family) who relies on someone else for financial support for healthcare expenses, covered under an insurance policy.
  13. 22. A fixed amount a patient must pay for medical services before their insurance starts covering the costs. For instance, if this amount is $1,000, the patient pays the first $1,000 of their healthcare expenses directly to the provider. Once this amount is met, insurance will begin to cover the costs of covered services.
  14. 23. A doctor for general health issues, routine check-ups, and preventive care. They can be a doctor, nurse practitioner, or physician assistant. They also help you see specialists if needed.
  15. 24. Healthcare services that are not included in your insurance plan and you have to pay for yourself.
  16. 26. The highest amount of money or maximum number of visits an insurance policy will pay for covered services.
  17. 27. The person who holds the insurance policy and is responsible for its premium to the insurance company.
  18. 31. A written agreement between an insurance company and the insured that outlines the terms of coverage.