Across
- 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
Down
- 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