Across
- 1. Federal health insurance program for U.S citizens who are at least 65 years of age or are a qualifying disabled person
- 6. A request that can be submitted to ask an insurance plan to re-determine coverage for a non-formulary drug
- 7. Specific to pharmacy benefits, a decision made by the insurance plan to determine whether a health care service is medically necessary
- 8. Fixed out-of-pocket costs charged to patients for services rendered
- 10. A type of medical insurance plan that provides benefits for a broad range of healthcare services both inpatient & outpatient
- 11. The estimated cost of the insurance plan
- 13. Federal and state government funded program for eligible low income adults and seniors, parents and children, individuals with disabilities and pregnant persons
- 16. Written or oral expression of dissatisfaction regarding the plan or provider
Down
- 2. The percentage of the total cost of services the patient will be responsible for
- 3. The amount that must be paid out of pocket before the insurance company will begin paying towards most covered expenses
- 4. Medicare Plan the covers prescription drugs
- 5. abv. the maximum amount a patient will pay during a policy period before the plan begins to pay 100% of the allowed amount
- 9. Abv. Plans that employers use often through a third party vendor, that guide patients towards utilizing patient assistance programs rather than the employer covering the cost
- 12. Supplemental insurance that can assist with patient out of pocket costs associated with copays, coinsurances or deductibles
- 14. A request for the plan to review a decision or grievance
- 15. Abv. Medicare financial assistance that lowers the cost of Part B and D premiums as well as lowering the cost of prescription drugs