Health Insurance

3. determines how each plan covers different types of prescription drugs where each tier is typically assigned a cost you will pay for drugs listed in that tier
4. Insurance program that provides free or low-cost health coverage to some low-income people; families and children; pregnant women; the elderly; and people with disabilities
6. insurance plan that employers are required to have to cover employees who get sick or injured on the job
8. A federal health insurance program for people 65 and older and certain younger people with disabilities (also covers people with End-Stage Renal Disease)
12. After you spend this amount on deductibles, copayments, and coinsurance for in-network care and services, your health plan pays 100% of the costs of covered benefits
13. A written order from your primary care doctor for you to see a specialist or get certain medical services
15. amount you owe for covered health care services before your health insurance or plan begins to pay
16. amount you pay for your health insurance or plan each month

1. Your share of the cost for a covered health care service, usually calculated as a percentage (like 20%) of the allowed amount for the service
2. The doctors hospitals and suppliers your health insurer has contracted with to deliver health care services to their members
5. a coverage gap in most Medicare Part D prescription drug plans where once you and your plan pay a certain amount you are in the “gap” until catastophic coverage kicks in
7. prescription drug that has the same active-ingredient formula as a brand-name drug
9. low-cost health coverage to children in families that earn too much money to qualify for Medicaid but not enough to buy private insurance
10. A federal law that may allow you to temporarily keep health coverage after your employment ends; you lose coverage as a dependent of the covered employee; or another qualifying event
11. amount you pay as your share of the cost for a medical service or item
14. request for payment that you or your health care provider submits to your health insurer when you get items or services you think are covered