Glossary
Look up a benefis-related team below:
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Urgent Care
Care for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not Read More
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UCR (Usual, Customary and Reasonable)
The amount paid for a medical service in a geographic area based on what providers in the area usually charge Read More
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Specialist
A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or Read More
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Reconstructive Surgery
Surgery and follow-up treatment needed to correct or improve a part of the body because of birth defects, accidents, injuries Read More
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Primary Care Provider
A physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine), nurse practitioner, clinical nurse specialist or physician Read More
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Preauthorization
A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical Read More
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Out-of-Pocket Limit
The most you pay during a policy period (usually a year) before your health insurance or plan begins to pay Read More
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Out-of-network Co-insurance
The percent (for example, 40%) you pay of the allowed amount for covered health care services to providers who do Read More
![](https://fh-insurance.com/wp-content/uploads/2022/10/AdobeStock_112190473-1024x683.jpeg)
Non-Preferred Provider
A provider who doesn’t have a contract with your health insurer or plan to provide services to you. You’ll pay Read More
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Medically Necessary
Health care services or supplies needed to prevent, diagnose or treat an illness, injury, condition, disease or its symptoms and Read More
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In-network Co-payment
A fixed amount (for example, $15) you pay for covered health care services to providers who contract with your health Read More
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In-network Co-insurance
The percent (for example, 20%) you pay of the allowed amount for covered health care services to providers who contract Read More
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Hospital Outpatient Care
Care in a hospital that usually doesn’t require an overnight stay. Back to Glossary Interested in a Free Benefits Consultation? Read More
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Hospitalization
Care in a hospital that requires admission as an inpatient and usually requires an overnight stay. An overnight stay for Read More
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Health Insurance
A contract that requires your health insurer to pay some or all of your health care costs in exchange for Read More
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Excluded Services
Health care services that your health insurance or plan doesn’t pay for or cover. Back to Glossary Interested in a Read More
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Emergency Medical Transportation
Ambulance services for an emergency medical condition. Back to Glossary Interested in a Free Benefits Consultation? LET’S MEET
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Emergency Medical Condition
An illness, injury, symptom or condition so serious that a reasonable person would seek care right away to avoid severe Read More
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Deductible
The amount you owe for health care services your health insurance or plan covers before your health insurance or plan Read More
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Co-Payment
A fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service. Read More
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Co-Insurance
Your share of the costs of a covered health care service, calculated as a percent (for example, 20%) of the Read More
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Balance Billing
When a provider bills you for the difference between the provider’s charge and the allowed amount. For example, if the Read More
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Allowed Amount
Maximum amount on which payment is based for covered health care services. This may be called “eligible expense,” “payment allowance” Read More