Glossary: Health Care and Insurance Terms
Understanding health insurance can be complicated. Below are common definitions of frequently used terms and services. View more healthcare definitions at healthcare.gov.
A-C
- Boynton Health: the on-campus health clinic supported by your Student Services Fee and health insurance on the Twin Cities campus. You can go to Boynton Health for your routine check-up, if you get sick or injured, or to get medicine
- Claim: a request for payment sent by a provider to the health insurance company when you receive a service
- Co-insurance: the percentage of costs of a covered service after you’d paid your deductible
- Co-pay: a fixed amount to be paid for a covered service
- Coordination of Benefits (COB): a way to determine which insurance plan will pay for a service first when two or more plans are held
- Covered Benefits: a health service or item that is included in your health plan that is paid either partially or in full
D-F
- Deductible: the amount you pay for covered services before the insurance plan starts to pay.
- Durable Medical Equipment (DME): equipment and supplies ordered by a provider for everyday or extended use (ex.: crutches)
- Emergency Room (ER): an emergency room or ER, is a medical facility open 24 hours a day that treats acute illness and injury that poses an immediate risk to a person’s life or long-term health. You do not need an appointment to go to the ER.
G-K
- In-Network: the facilities and providers that your health insurer has contracted with to provide health care services
- Immunizations: An immunization helps your body fight off specific diseases and is administered via vaccination. Boynton Health provides a variety of immunizations to University students.
L-O
- Medically Necessary: health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms that meet accepted medical standards.
- Non-Covered Benefits or Exclusions: health services that the insurance plan does not pay for or cover
- Open-enrollment Period: the annual time frame when people can easily enroll in an insurance policy (time may vary depending on the plan)
- Out-of-Network: the facilities and providers not contracted with your health insurer for services
- Out-of-pocket maximum: the most you have to pay for covered services within a plan year
before the health plan pays 100% of the costs of covered benefits.
P-Q
- Plan Year: a 12-month period of benefits coverage under a health plan (may not be the same as a calendar year)
- Preauthorization: a decision by the health plan that a service, treatment plan, prescription drug, or durable medical equipment is medically necessary.
- Preferred Provider Organization (PPO): a type of health plan that contracts with medical providers (hospitals and doctors) to create a network of participating providers.
- Premium: the amount you pay for active health insurance every month
- Prescription: A prescription is a medicine that is prescribed to you by a doctor. You need to fill your prescription at a pharmacy. There is usually a co-pay for the prescription. Members of the Student Health Benefit Plan should fill their prescriptions at the Boynton Health Pharmacy.
- Primary Care: health services that covered a range of prevention, wellness, and treatment for common illnesses
- Prior Authorization: approval from a health plan that may be required before having a service performed or a prescription filled so that it is covered by the plan
- Provider: a doctor or other health professional that provides health care services
- Quick Clinic or Convenience Care: a type of walk-in clinic that treats minor illnesses and provides basic preventive health services. You do not need an appointment at this type of clinic. There is a quick clinic at Boynton Health, called the Gopher Quick Clinic.
R-Z
- Subscriber: the primary person on an insurance policy who is responsible for paying for costs associated with the plan and enrolled dependents
- Urgent Care: services for an illness, injury, or condition serious enough to seek care right away, but not so severe as seeking emergency room care