Health Insurance Glossary
Health / Health Insurance Glossary
Medical Advisory Committee: Committee whose purpose is to review general medical management issues brought to it by the medical director.
Medical Director: Manager in a healthcare organization responsible for provider relations, provider recruiting, quality and utilization management, and medical policy.
Medical Foundation: A not-for-profit entity, usually created by a hospital or health system, that purchases and manages physician practices.
Medical Savings Account (MSA): A trust that employees of small businesses may establish to pay for out-of-pocket medical expenses.
Medical Underwriting: The evaluation of health questionnaires submitted by all proposed plan members to determine the insurability of the group.
Medically Needy Individuals: Enrollees in Medicaid programs whose income or assets exceed the maximum threshold for certain federal programs.
Medicare: A federal government hospital expense and medical expense insurance plan primarily for elderly and disabled persons. See also Medicare Part A, Medicare Part B, and Medicare Part C.
Medicare Choice MSAS: Accounts created by contributions from HCFA to pay out-of-pocket medical expenses for Medicare beneficiaries. The accounts are used in conjunction with high-deductible, catastrophic healthca . . . View Full Definition
Medicare Part A: The part of Medicare that provides basic hospital insurance coverage automatically for most eligible persons. See also Medicare.
Medicare Part B: A voluntary program that is part of Medicare and provides benefits to cover the costs of physicians' services. See also Medicare.
Medicare Part C: The part of Medicare that expands the list of different types of entities allowed to offer health plans to Medicare beneficiaries. Also known as Medicare+Choice. See also Medicare.
Medicare Supplement: A private medical expense insurance plan that supplements Medicare coverage. Also known as a Medigap policy.
Medigap Insurance Policies: Medigap insurance is offered by private insurance companies, not the government. It is not the same as Medicare or Medicaid. These policies are designed to pay for some of the costs that Med . . . View Full Definition
Member Services: The department responsible for helping members with any problems, handling member grievances and complaints, tracking and reporting patterns of problems encountered, and enhancing the relati . . . View Full Definition
Mental Health Parity Act (MHPA): A federal act which prohibits group health plans that offer mental health benefits from applying more restrictive limits on coverage for mental illness than for physical illness.
Merger: A type of structural integration that occurs when two or more separate providers are legally joined.
Messenger Model: A type of independent practice association (IPA) that simply negotiates contract terms with MCOs on behalf of member physicians, who then contract directly with MCOs using the terms negotiat . . . View Full Definition
Monthly Operating Report (MOR): A document that reports the month- and year-to-date financial status of a managed care plan.
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Profit And Loss Statement: A detailed statement of income and expenses of a business that reveals the operating position of the business over a period of time. Commonly referred to a P&L.
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