- Industry: Insurance
- Number of terms: 2862
- Number of blossaries: 0
- Company Profile:
Aetna, Inc. is an American diversified health insurance company, providing a range of traditional and consumer directed health care insurance products and related services, including medical, pharmaceutical, dental, behavioral health, group life, long-term care, and disability plans, and medical ...
These are legal conditions. They apply to health plans. They list specifically what is and what is not covered by the plan.
Industry:Health care
This means a condition is dangerous. You could lose your life. Do not wait to call a doctor.
Industry:Health care
This is a group that sets up and manages a health plan or group insurance plan. It can be an employer. It can also be a labour union, government agency or nonprofit group.
Industry:Health care
This is the total dollar amount of benefits you can receive. It can also be the total number of services you can receive. These totals are limits for a lifetime, not just for a plan year.
Industry:Health care
This is a type of health plan. It lets members see participating providers. They can also see nonparticipating providers. In many POS plans, members who use referrals and see a Primary care physician(PCP) get more coverage. They may pay less for care. Members can get care from a provider who is not a PCP. They might pay more for care.
Industry:Health care
These are restrictions that health plans place on coverage. They say what your plan does not cover.
Industry:Health care
These are fats in the blood. Lipids and protein help fuel the body. Cholesterol and triglycerides are types of lipids. They need to be checked regularly. High levels can be dangerous. They can build up in your blood vessels and arteries and lead to heart attack and stroke.
Industry:Health care
These are for doctors. They describe the best possible methods to diagnose and treat illness or injury. They are based on medical research. Some call them: clinical practise guidelines; practise parameters; medical protocols.
Industry:Health care
This is an important process. It is approval a person gets for care before he or she receives the care. This helps people know if the care is covered by a health plan. People should cheque with their plan to see what kind of service needs this approval. This can also be called: precertification (In Texas, this approval is known as “pre-service utilisation review” and is not “verification” as defined by Texas law.); authorization; certification; prior authorization.
Industry:Health care
