GlossaryHealth InsuranceT to V
You will find an expanded list and definition of terms in this glossary health insurance T to V section.
Use it often, especially when you begin to review your health insurance policy and benefits.
T
Temporary Assistance for Needy Families (TANF): A program that seeks to
provide cash benefits
to lower income families with children. If you qualify for TANF, then you
generally also qualify for
Medicaid.
third-party administrator (TPA): An outside person or firm which provides
specific administrative
duties (including premium accounting, claims review and payment, arranges for
utilization review
and stop-loss coverage) for a self-funded plan.
third-party payer: Any payer for health care services other than the
insured. This can be an
insurance company, an HMO, a PPO, or the Federal Government.
trend factors: The percentage of increase used by an actuary to reflect
the projected rise in health
care costs overall. Calculation factors include inflation, utilization,
technology and geographic
area.
U
uninsurables: High-risk uninsured persons whose medical condition(s)
precludes them from
buying health insurance.
urgent care: Immediate care given to address a medical emergency that has
not yet reached the
level of extreme emergency. Most managed care plans require you to seek urgent
care at a
participating urgent care facility or hospital.
usual, reasonable, and customary: The amount that is considered the
normal payment range for
a specific medical procedure performed within a given geographic area. Your
health insurance
company may not allow the full amount charged to you, if it is higher than what
is considered
normal for the covered health care services.
V
vision care coverage: A type of specified expense coverage that provides
benefits for expenses
you incur in obtaining eye examinations and corrective lenses.
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