Health Insurance terms starting with E

25 terms

  1. Early and Periodic Screening, Diagnostic, and Treatment Services (EPSDT) A term used to refer to the comprehensive set of benefits covered for children in Medicaid.
  2. Eligibility Assessment In certain states, the Marketplace doesn't provide the final decision on Medicaid eligibility.
  3. Eligibility determination A notice sent by MNsure to let a MNsure consumer know the decision about whether the consumer qualifies (is eligible) for MNsure programs.
  4. Eligible Immigration Status An immigration status that's considered eligible for getting health coverage through the Marketplace.
  5. Elimination Period If you have disability insurance or long-term care insurance, there's a waiting period, called the elimination period, from the time you become disabled…
  6. Emergency Medical Condition An illness, injury, symptom or condition so serious that a reasonable person would seek care right away to avoid severe harm.
  7. Emergency Medical Transportation Ambulance services for an emergency medical condition.
  8. Emergency Room Care Emergency services you get in an emergency room.
  9. Emergency Services Evaluation of an emergency medical condition and treatment to keep the condition from getting worse.
  10. Employee Retirement Income Security Act of 1974 (ERISA) is a comprehensive and complex statute that federalizes the law of employee benefits.
  11. Employer Choice, Employee Choice Employer choice allows small employers to select one insurance company and allow employees to choose from any plans offered by that company across all…
  12. Employer Contribution Employer contribution is the amount or percentage of health care premiums contributed by employers for employees’ health insurance.
  13. Employer or Union Retiree Plans Plans that provide health and/or drug coverage to former employees or members, and, in some cases, their families.
  14. Employer Shared Responsibility Payment (ESRP) The Affordable Care Act requires certain employers with at least 50 full-time employees (or equivalents) to offer health insurance coverage to its…
  15. Essential Benefits The ACA requires all health insurance plans sold after 2014 to include a basic package of benefits including hospitalization, outpatient services…
  16. Essential Health Benefits A set of health care service categories that must be covered by certain plans, starting in 2014.
  17. Evidence-Based Medicine In evidence-based medicine, treatment success is measured by a careful study of the outcome, using both the clinical expertise of the provider, as well as…
  18. Exchange An exchange generally occurs when one company acquires another. The shareholders of the acquired company are often given the option to sell their shares…
  19. Excluded Drugs Drugs not covered by the insurance policy.
  20. Excluded Services Health care services that your health insurance or plan doesn’t pay for or cover.
  21. Exclusion A contractual provision in an insurance policy that denies or restricts coverage for certain perils, persons, property or locations.
  22. Exclusions and/or Limitations Conditions or circumstances spelled out in an insurance policy which limit or exclude coverage benefits.
  23. Exclusive Provider Organization (EPO) Plan A managed care plan where services are covered only if you go to doctors, specialists, or hospitals in the plan’s network (except in an emergency).
  24. Experimental and/or Investigational Medical Services A drug, device, procedure, treatment plan, or other therapy which is currently not within the accepted standards of medical care.
  25. External Review A review of a plan's decision to deny coverage for or payment of a service by an independent third-party not related to the plan.