Across
- 3. Requires to try and fail preferred medication before providing coverage for the prescribed non-preferred medication
- 8. A list of prescription drugs that a plan covers
- 9. Signed into law in 2010 to expand access to insurance, increase consumer protections, emphasize prevention
- 12. A pre-determined annual amount policy holder pays before insurance begins to cover
- 13. Allows policy holders freedom to choose providers outside of the plan network
- 14. The most you pay for covered services in a plan year
- 15. Health plans contract with for processing and paying prescription drug claims
Down
- 1. Focuses on high cost, biotech drugs such as injectable or inhaled medications
- 2. A payment model where services are unbundled and paid for separately
- 4. Providers that contract with your health plan to provide services for an agreed-upon rate
- 5. A tax-free account that an employee owns to save for medical expenses now and in the future
- 6. Any equipment that provides therapeutic benefits to a patient in need because of certain medical condition
- 7. A Monthly fee you pay to maintain health coverage
- 10. A fixed dollar amount the policy holder pays for covered health services
- 11. Requires referrals from a PCP for specialized care