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Tag Archives: health insurance terms to know

What is a referral in healthcare?

Referrals refer to two important functions in healthcare. First, the traditional medical definition is to issue a recommendation for a patient to see a designated doctor or type of medical care provider. This kind of referral is the customary practice when an attending doctor senses a condition that is outside of his or her area […]

What is a health plan Navigator? defines the navigator position as individual or organization trained in assisting small businesses, employees and consumers with searching for coverage options in the Affordable Care Act marketplace and completing the required forms. The services provided by navigators are free. Navigators are required to remain unbiased when fulfilling their duties. Section 1311(i) of the ACA […]

What does “UCR” mean in health insurance?

Usual, customary and reasonable (UCR) is a method for determining the price of a covered benefit or service. Insurers can use research from a specialist company or use their experience in a given market to determine the usual, customary, and reasonable price. Once they find an average range for the territory or market, the insurer […]

What does “PD” mean in medical terms?

In medical terminology, PD is a symbol for prescription drugs. The designation appears in many standard names and labels. Prescription drugs are an important part of modern medical care both inpatient hospitalization and outpatient care. Higher prices come along with the advances and increased effectiveness of prescription medicines. Comparison shopping can help consumers find the […]

What does “out-of-pocket” mean in health care?

When choosing a health insurance plan, it’s important to consider all of the costs that you could potentially be responsible for. Many health insurance plans require a monthly premium. The premium is the cost of obtaining the insurance, and it must be paid to keep the insurance active. In addition, there are out-of-pocket costs. These […]

How to Get a Medical Insurance Card

Medical insurance cards are universally recognized as something that everybody should carry on their person at all times. If you are injured and unable to communicate with health insurance providers, they will be able to check your medical insurance card and get the information they need. Even if you are not injured and can communicate […]

What does “plan sponsor” mean?

In the insurance industry, there are various parties who may set up insurance policies for you. If it is an individual health insurance policy, usually the person or persons on the policy will work with an insurance expert such as an insurance agent or company. If it is a group health insurance policy, the employee […]

What does “policyholder” mean for insurance?

When discussing insurance, one of the terms that is most frequently used is policyholder. However, it can remain ambiguous exactly what this means and the precise definition can vary depending upon the situation. It means something different for private health insurance than it does for public health insurance programs like Medicare or Medicaid. Need insurance? […]

What is a stop loss provision in health insurance?

There are many policies and procedures governing the execution of health insurance policies in this country, Some are rather straightforward and easy to understand and implement, while others are a bit more complex. Here we examine the often misunderstood notion of the stop loss provision. Our site makes finding and understanding health insurance a bit […]

What does a “rider” mean in health insurance?

There are a variety of health insurance plans available. Within each plan, there is also the possibility for further variance. Riders, which are essentially amendments to a coverage plan, can be added on a case-by-case basis. These health care riders can expand coverage for an additional cost and make the overall plan more suited for […]

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