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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
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The following terms and concepts are common to insurance plans. Some are not used in the traditional versions of particular types of plans. For instance, HMOs do not include co-insurance. Fee-for-service (Indemnity) Plans do not include co-pays. However, since plans today are often hybrids, the provisions are discussed together.

  • Adverse Determination
  • Co-insurance
  • Co-pay
  • Covered charges
  • Deductible
  • Formulary
  • Lifetime Maximum (NOTE: Thanks to Health Reform 2010, health plans issued on or after September 23, 2010 cannot include a lifetime maximum.)
  • Medical necessity
  • "Stop Loss," "Cap," or "Out-of-pocket Maximum"
  • Usual, Customary and Reasonable
  • Utilization Management

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More Information

Types Of Health Insurance Policies

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