MSA (Medical Savings Account)
A tax-advantaged personal savings account used in conjunction with a high deductible health policy. Individuals can contribute money to this account on a pre-tax basis to set aside money for qualified medical care and expenses, including annual deductibles and copayments.

Major Hospitalization Policy
The same as Major Medical Insurance, except that it applies to expenses incurred only when the insured is hospitalized. See also Major Medical Insurance.

Major Medical Insurance
A type of Health Insurance that provides benefits up to a high limit for most types of medical expenses incurred, subject to a large deductible. Such contracts may contain limits on specific types of charges, like room and board, and a percentage participation clause sometimes called a coinsurance clause. These policies usually pay covered expenses whether an individual is in or out of the hospital.

Managed Care
A system of health care where the goal is a system that delivers quality, cost effective health care through monitoring and recommending utilization of services, and cost of services.

Managed Care Organization (MCO)
An umbrella term for health plans that provide health care in return for a set monthly payment and coordinate care through a network of physicians and hospitals. Health maintenance organizations and point-of-service plans are managed care organizations.

Medicaid
A state-funded health care program for low income or disabled persons.

Medicare+Choice
An expanded set of options for the delivery of health care under Medicare established by the Balanced Budget Act of 1997. Most Medicare beneficiaries can choose to receive benefits through the original fee-for-service program or through one of the following Medicare+Choice plans (1) coordinated care plans (such as health maintenance organizations, provider sponsored organizations, and preferred provider organizations); (2) Medical Savings Account (MSA)/High Deductible plans (through a demonstration available to up to 390,000 beneficiaries); or (3) private fee-for-service plans.

Medicare Economic Index (MEI)
An index which is often used in the calculation of the increases in the prevailing charge levels that help to determine allowed charges for physician services. In 1992 and later, this index is considered in connection with the update factor for the physician fee schedule.

Medicare Supplement Insurance
Insurance coverage sold on an individual or group basis which helps to fill the gaps in the protection provided by the Medicare program. Medicare supplements cannot duplicate any benefits provided by Medicare, but may pay part or all of Medicare's deductibles and copayments, and may cover some services and expenses not covered by Medicare.

Point-of-Service (POS) Plan
A type of managed care plan combining features of health maintenance organizations (HMOs) and preferred provider organizations (PPOs). You can decide whether to go to a network provider and pay a flat dollar or to an out-of-network provider and pay a deductible and/or a coinsurance charge.

PPO (Preferred Provider Organization)
A Preferred Provider Organization (PPO) provides a list of contracted "preferred" providers from which to choose. You receive the highest monetary benefit when you limit your health care services to those providers on the list. If you go to a doctor or hospital that is not on the preferred provider list referred to as going "out-of-network", then the plan covers a smaller percentage of your health care expenses or may cover none of your health care expenses based on the contract wording of the plan. Always check with your PPO or consult your list of preferred providers before you seek health care services to make certain your physician or hospital is a contracting provider (part of the network). Make sure that your doctor refers you to health care providers within your PPO network, if applicable.

PPOs can be regulated by either the CDI or the Department of Managed Health Care (DMHC) depending on whether the underwriting company (the company backing the policy) is a licensed insurance company or a managed care company. If you are confused about whom to call regarding a PPO problem or concern, then consult your plan documents for regulatory information.

Important Points to Remember About Preferred Provider Organizations:

• You receive the highest monetary benefit when staying within the PPO network.
• You may have the option to go outside the PPO network at a higher monetary cost to you.
• You should consider checking if your doctor or any specialist referred to you is part of the PPO network before utilizing covered services.
• You can contact either the CDI or the DMHC for clarification regarding PPO issues.

Short-term Health Insurance Policies
Short-term plans are similar to standard, individual and family health plans, except they are designed to provide coverage for only 1 to 12 months.

Small Group Plans (SG or SBG)
An insurance contract that covers a group of individuals who are affiliated in some way, either through an employer, trade association, or other organization.

Student Health
Permanent type, renewable individual health insurance. It is designed specifically for full-time college students, any age.

Supplemental Health Insurance Policies
Most supplemental health insurance policies are designed to pay in addition to your comprehensive major medical coverage. These supplemental policies should not be used as a substitute or replacement for a traditional health insurance policy or a health plan. Supplemental health insurance can pay limited benefits such as a daily dollar amount if you are hospitalized (hospital income policy) or a lump sum dollar amount if you are diagnosed with a specified or named disease, such as cancer. This type of supplemental policy can also be structured to pay expenses incurred in the treatment of the specified disease. Sometimes this insurance provides payment over and above your medical expenses. It is important that you understand the limitations and exclusions of supplemental health insurance policies and how the policies coordinate benefits, so that you can make the best decision based on your needs and your budget.

Travel Medical Insurance
Provides benefits to cover medical bills while you are traveling outside of your home country. Most policies also include other non-medical coverage, i.e. Trip Cancellation and Emergency Evacuation.

Vision Care Coverage
A health care plan usually offered only on a group basis which covers routine eye examinations, and which may cover all or part of the cost of eyeglasses and lenses.