Glossary of insurance terms
- Care management
- Claim
- Clinical Practice Guidelines
- Certificate of coverage (COC)
- COC
- Coinsurance
- Coinsurance Maximum
- Complication of pregnancy
- Copayment
- Cost sharing
- Covered, coverage
- Coverage documents
- CPT
- Electronic Data Interchange (EDI)
- Electronic Funds Transfer (EFT)
- Emergency medical condition
- Emergency medical transportation
- Emergency room care
- Emergency services
- Explanation of Benefits (EOB)
- Essential health benefits
- Excluded services
- Habilitative services
- HCFA
- HCPCS codes
- HDHP
- Health insurance
- Health maintenance organization (HMO)
- Health reimbursement account (HRA)
- Health savings account (HSA)
- High-deductible health plan (HDHP)
- HMO
- HMO plan
- Home health care
- Hospice services
- Hospitalization
- Hospital outpatient care
- HRA
- HSA
- Patient-centered medical home (PCMH)
- PCMH
- PCP
- Physician services
- Plan
- Point of service (POS) plan
- POS
- PPO
- Practice guidelines
- Preauthorization
- Preferred benefits
- Preferred provider
- Preferred provider organization (PPO)
- Premium
- Prescription drug coverage
- Prescription drugs
- Preventive care
- Primary care
- Primary care provider (PCP)
- Product
- Provider
Health insurance and managed care are complicated topics. We hope these definitions help you make sense of your coverage. Many of these definitions were taken from the National Committee for Quality Assurance (www.ncqa.org) and United States Department of Labor (www.dol.gov) websites.