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Glossary of Terms
Home | Glossary of Terms
- 01
Financial aid programs that help patients pay for their prescription medication costs, often provided by drug manufacturers or charities. They reduce out-of-pocket expenses for eligible patients.
- 02
Insurance policies that prevent copay assistance from counting toward a patient's deductible or out-of-pocket maximum. This means patients may still have to pay full costs once assistance runs out.
- 03
The practice of making healthcare prices and costs clear and accessible to patients before they receive treatment. This helps people make informed financial decisions about their care.
- 04
Laws requiring health insurance to cover mental health care just as they do physical health care. This ensures fair treatment for conditions like depression or anxiety.
- 05
When insurance companies change coverage rules, forcing patients to switch medications for financial reasons rather than medical necessity. This can disrupt treatment and cause side effects.
- 06
The organization or entity, such as an insurance company or government program, that pays for healthcare services. They determine what treatments and medications are covered.
- 07
A middleman company that manages prescription drug benefits for insurance plans. PBMs negotiate drug prices and decide which medications are covered.
- 08
A requirement from insurance companies that a doctor must get approval before prescribing certain medications or treatments. Without approval, the insurance may not cover the cost.
- 09
Any healthcare professional or facility that delivers medical care, such as doctors, nurses, hospitals, and clinics. They diagnose, treat, and manage patients' health.
- 10
A policy that aims to make medical services cost the same regardless of where they are provided, such as a hospital or a doctor’s office. This prevents higher charges just because of the location.
- 11
A process where insurance requires patients to try and fail on cheaper medications before covering a more expensive or brand-name drug. It can delay access to the most effective treatment.
- 12
When a healthcare company expands by owning different parts of the healthcare system, such as hospitals, insurance plans, and pharmacies. This can increase efficiency but may also reduce competition.