Pharmaceuticals prescribed for ongoing use in the treatment of chronic conditions. Examples include asthma medication or diabetes supplies.
Malpractice occurs when a professional is negligent or incompetent and their actions are careless, wrong or illegal. Medical malpractice is when a medical professional is negligent.
Insurance for doctors and health care providers that covers the cost of malpractice lawsuits.
A health delivery system that aims to limit health care costs and improve the quality of care by controlling access to the use of health care services.
Managed Care Organization (MCO)
Organizations that provide managed care but have different business models. The organizations are also made up of a variety of physicians, hospitals and other providers.
Specific benefits that are required to be covered by health insuring agencies plans. The number and type of benefits vary across states.
The size of one firm relative to its competitors in a given market. Certain insurers or health systems have greater market power which enhances their ability to set prices.
Maximum Monthly Coverage
Maximum dollar amount that a disabled individual can receive in a given month.
Maximum Reimbursable Charge
Dollar limit on health care services, typically only applies to out of network coverage.
A health insurance program managed by the state but jointly funded by the state and Federal government for children and adults with low incomes.