Appendix B: Effective Terminology
Effective Terminology For Insurance Companies, Medicaid, or Medicare
"significantly improves condition of patient"
"medically necessary"
"prosthesis to replace organ or limb"
"replaces a non-functional part of patient's body"
"other therapeutic and prosthetic services and supplies"
"durable medical equipment"
"improvement of a malformed body member"
"restoration of patient to best possible functional level"
As you investigate the possible avenues of funding for assistive technology, keep in mind that some options may affect your own insurance policies in the future.
Definitions
Co-payment: Specified charges that must be paid each time care or medical services of a particular type are received. The instances in which a co-payment will be required are specified in your policy's schedule of benefits. The co-payment must be paid before any other payment will be made for that specific benefit. The co-payment amount does not count toward satisfaction of the insured's deductible or out of pocket maximum for the plan year.
Deductible: The amount the insured must pay on covered benefits before the insurance company will pay during a benefit period.
Life Time Cap: The maximum amount (limit) that the insurance company is obligated to pay for all medical care during the life time of the insured.
