DOCUMENT
Aetna Glossary
434 definitions by Aetna Inc.

Accelerated Death BenefitAccelerated Death BenefitAccidental Death and DismembermentAccidental Death and Personal LossAccidental Death and Personal Loss CoverageAccountable Care OrganizationAccreditationActive Full-Time EmployeeAdjudicationAdjusted Pre-disability EarningsAdvance DirectiveAetna HealthFundAetna Mobile ApplicationAexcelAge Discrimination Employment ActAge Discrimination Employment ActAlcohol & Drug Restriction or LimitationAllowable expense(s)Allowed mountAmbulatory CareAmbulatory SurgeryAmericans with Disabilities ActAmericans with Disabilities ActAncillary ServicesAnnual Coordinated Election PeriodAny OccupationAppeals ProcessAuthorizationBalance BillingBalance Billing (Medicare)Bariatric SurgeryBehavioral HealthBeneficiaryBeneficiary (Medicare)BenefitBenefit DurationBenefit MaximumBenefit PeriodBoard CertifiedBrokerCapitationCareer CounselingCase ManagementCenters for Medicare & Medicaid ServicesCenters for Medicare & Medicaid ServicesCertificate of CoverageCertificationCertification of a Period of DisabilityCertified Financial PlannerTMChemotherapyChiropractic CareClaimClinical Policy BulletinsClosed FormularyCoinsuranceCombined Life Insurance MaximumCommon-Law MarriageComplication of PregnancyCompositeCongenitally Missing TeethConsumer-Directed Health PlanConsumerismContract (also known as a “Benefit certificate” or “Policy”)Contract HolderContributoryConversion ChargeConversion OptionCoordination of BenefitsCopayCopaymentCost of Living AdjustmentCost of Living AdjustmentCoverage GapCovered services (also Covered benefits or Covered expenses)CredentialingCreditable CoverageCreditable Coverage—MedicareCustodial CareCustomary and ReasonableDate Claim IncurredDate Claim IncurredDate Claim ReceivedDate Last WorkedDate Last WorkedDate of disability (also known as “Date of claim” or “Incurred date”)Day Treatment CenterDeath Benefit (also known as “Face amount”)DeductibleDeductible (Medicare)Defined Contribution PlansDependentDependent Care Reimbursement AccountDiagnostic TestsDirect Access (Also “Open access”)DisabilityDisability and Absence ManagementDisability PaymentDisease ManagementDocFindDomestic PartnersDonut Hole (Medicare)DrugDrug FormularyDrug TiersDual Eligibles (Medicare)Duplicate CoverageDurable Medical EquipmentDurable Medical Equipment (Medicare)Durable Medical Equipment or Durable Medical Equipment (Medicare)Earnings DefinitionEffective DateElectronic Health RecordEligibilityElimination PeriodEmergencyEmergency FacilityEmployee Assistance ProgramEmployee Assistance ProgramEmployee Retirement Income Security Act of 1974Employee Retirement Income Security Act of 1974EnrolleeEnrollment Period (Medicare)Ergonomic EvaluationErgonomicsEvidence-Based MedicineEvidence of InsurabilityEvidence of Insurability (EOI, also known as “Medical underwriting”)ExclusionsExperimental Services or ProceduresExplanation of BenefitsExplanation of BenefitsFace AmountFacility-of-Payment ProvisionFamily and Medical Leave ActFamily and Medical Leave ActFederal Employees Health Benefits ProgramFederal Employees Health Benefits ProgramFee for ServiceFlexible Spending AccountFlexible Spending AccountFormularyFormulary Exclusion ListFully Insured EmployersFunctional Capacity EvaluationGeneric DrugGroup CoverageGroup Universal LifeGroup Universal LifeGuarantee Issue MaximumHealth AssessmentHealth Benefits PlanHealth Care ConsumerismHealth FundHealth Insurance CarrierHealth Insurance Portability and Accountability ActHealth Insurance Portability and Accountability ActHealth Maintenance OrganizationHealth Maintenance OrganizationHealth Maintenance OrganizationHealth Reimbursement ArrangementHealth Reimbursement ArrangementHealth Savings AccountHealth Savings AccountHigh-Deductible Health PlanHigh-Deductible Health PlanHome Health CareHome Infusion TherapyHospiceHospitalID CardIndemnity PlanIndependent Medical ExamIndependent Practice AssociationIndependent Practice AssociationIndividual PolicyIndividual Retirement AccountIndividual Retirement AccountInfusion TherapyInitial Coverage LimitInitial Enrollment PeriodInjectable DrugIn NetworkInpatientInpatient CareInsurance CardIntegrated Health and DisabilityInteliHealthInvestigational ServicesJob AnalysisJob-Seeking Skills TrainingLapse (or lapse in coverage)Late entrant (also known as late enrollee)Length of DisabilityLength of StayLevel Amount Schedule (also known as flat amount)Life insuranceLife ThreateningLifetime MaximumLimitationsLiving WillLong-Term Care InsuranceLong-Term Care ServicesLong Term DisabilityLong Term Disability (LTD) Pension AccrualLong Term Disability Pension SupplementLook-Back PeriodLowest Average Wholesale PriceMail-Order DrugsMail-Order PharmacyMaintenance MedicationsMalignantManaged CareManaged Care CompanyMandated BenefitsMA-PD PlanMaximum Benefit AmountMaximum Benefit PeriodMaximum Drug BenefitMedicaidMedical EmergencyMedically NecessaryMedical UnderwritingMedicareMedicare Advantage PlanMedicare Limiting ChargeMedicare Modernization ActMedicare Part AMedicare Part BMedicare Part CMedicare Part DMedicare Prescription Drug PlanMedicare Prescription Drug PlanMedicare Supplement PlanMedicationMedigapMemberMember Payment EstimatorMember ServicesMembraneMenopauseMental DisorderMetastatic (metastasize)MethodologyMgMicroalbuminuriaMinimum BenefitModifyMonitorMonthly BenefitNasal CongestionNational AdvantageNational Committee for Quality AssuranceNational Committee for Quality AssuranceNational Medical Excellence ProgramNauseaNecessaryNetworkNoncancerousNoncontributoryNon-occupational DiseaseNon-occupational InjuryNonparticipating ProviderNonprescriptionNutrientOccupational Injury/DiseaseOccupational TherapyOpen AccessOpen EnrollmentOpen FormularyOptimumOralOral and Maxillofacial SurgeonOriginal Medicare PlanOrthodontistOther Income BenefitsOut of NetworkOut-of-Pocket CostsOut-of-Pocket MaximumOutpatient CareOutpatient ProcedureOver-the-Counter DrugsPalliative CarePartial Day TreatmentPartial DisabilityParticipating PharmacyParticipating ProviderPatient-Centered Medical HomePatient Protection and Affordable Care ActPediatric DentistPending ClaimPensionPeriodontal DiseasePeriodontistPermanent and Total DisabilityPermanent Partial DisabilityPersonal Health RecordPharmacyPharmacy and Therapeutics CommitteePharmacy CopayPhysical AssistantPhysical ReactionPhysical TherapyPhysicianPlaceboPlan DocumentsPlan Exclusions and LimitationsPlan MaximumPlan SponsorPoint-of-ServicePoint-of-ServicePolicyPolicy HolderPortabilityPractice GuidelinesPreauthorizationPrecertificationPre-Disability EarningsPre-Existing ConditionPreferred Care ProviderPreferred Drug ListPreferred Provider OrganizationPreferred Provider OrganizationPremenstrualPremiumPremium WaiverPrescriptionPrescription DrugPrescription Drug PlanPrevailing ChargePreventive CarePrimary Care PhysicianPrimary Care PhysicianPrior AuthorizationPrior Creditable CoveragePrivate Fee-for-Service PlanProgressiveProphylaxisProsthetic DeviceProsthodontistProviderProvider NetworkPulmonary EmbolismQualified medical expenses (also known as eligible medical expenses)Qualifying EventRadiation TherapyReasonable ChargeReasonable Occupation or JobRecognized ChargeRecurrent DisabilityReferralRehabilitation ProgramReimbursementRelated AbsencesRelineRenewalRespiratory TherapyRespite CareRetireeRetiree Reimbursement AccountRetiree Reimbursement AccountRetirement RuleReturn-to-work IncentiveReturn-to-Work (RTW) IncentiveRiderRiskRollover FeatureRxSalary ContinuationSchedule of Benefits and ExclusionsSecond (surgical) opinionSection 213(d)Self-Funded PlanSelf-Insured EmployerSelf-Insured PlanService AreaShort-Term DisabilityShort-Term DisabilityShort-term Health InsuranceSicknessSkilled Nursing FacilitySkilled Nursing FacilitySmall Business Health InsuranceSocial Security Retirement BenefitsSpecial Benefit NetworksSpecial Election PeriodSpecial Election PeriodSpecialistSpecial Needs PlanSpecial Needs PlanSpeech TherapyStaff ModelStandard Industrial ClassificationState Insurance DepartmentState-Mandated BenefitsStep TherapyStop-Loss CoverageSubscriberSuccessive DisabilitiesSummary of Benefits and CoverageSupplemental Life InsuranceSupplemental medical insuranceSupplemental medical insuranceSurvivor BenefitTelemedicineTemporary Partial DisabilityTemporary Total DisabilityTemporomandibular JointTemporomandibular JointTemporomandibular Joint DisorderTemporomandibular Joint DisordersTerm InsuranceTertiary CareTotal Disability (any occupation)Total Disability (own occupation)Traditional PlanTransferable Skills AnalysisUncovered ServicesUnderwritingUrgent Care CentersUsual, Customary and ReasonableUsual, Customary, ReasonableVocational EvaluationVoluntary PlansW-2Walk-in ClinicWeekly BenefitWell Baby CareWell Child CareWellness ProgramsWell Woman CareWork AdjustmentWorkers' CompensationWork HardeningX-Ray
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Date
2015-02-17
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