Page 22 - Gerald R Ford International Airport Authority 2022 Benefits Guide

Glossary

● Brand preferred drugs – A drug with a patent and ● High Deductible Health Plan (HDHP) – A qualified High
trademark name that is considered “preferred” because Deductible Health Plan (HDHP) is defined by the Internal
it is appropriate to use for medical purposes and is Revenue Service (IRS) as a plan with a minimum annual
usually less expensive than other brand-name options. deductible and a maximum out-of-pocket limit. These
● Brand non-preferred drugs – A drug with a patent and minimums and maximums are determined annually and
trademark name. This type of drug is “not preferred” are subject to change.
and is usually more expensive than alternative generic ● In-network – A designated list of health care providers
and brand preferred drugs. (doctors, dentists, etc.) with whom the insurance provider
● Calendar Year Maximum – The maximum benefit has negotiated special rates. Using in-network providers
amount paid each year for each family member enrolled lowers the cost of services for you and the company.
in the dental plan. ● Inpatient – Services provided to an individual during an
● Coinsurance – The sharing of cost between you and overnight hospital stay.
the plan. For example, 80% coinsurance means the plan ● Mail Order Pharmacy – Mail order pharmacies generally
covers 80% of the cost of service after a deductible is met. provide a 90-day supply of a prescription medication for
You will be responsible for the remaining 20% of the cost. the same cost as a 60-day supply at a retail pharmacy.
● Copay – A fixed amount (for example $15) you pay for a Plus, mail order pharmacies offer the convenience of
covered health care service, usually when you receive shipping directly to your door.
the service. The amount can vary by the type of covered ● Out-of-network – Providers that are not in the plan’s
health care service. network and who have not negotiated discounted
● Deductible – The amount you have to pay for covered rates. The cost of services provided by out-of-network
services before your health plan begins to pay. providers is much higher for you and the company.
● Elimination Period – The time period between the Higher deductibles and coinsurance will apply.
beginning of an injury or illness and receiving benefit ● Out-of-pocket maximum – The maximum amount you
payments from the insurer. and your family must pay for eligible expenses each
● Flexible Spending Accounts (FSA) – FSAs allow you plan year. Once your expenses reach the out-of-pocket
to pay for eligible health care and dependent care maximum, the plan pays benefits at 100% of eligible
expenses using tax-free dollars. The money in the expenses for the remainder of the year. Your annual
account is subject to the “use it or lose it” rule which deductible is included in your out-of-pocket maximum.
means you must spend the money in the account ● Outpatient – Services provided to an individual at a
before the end of the plan year. hospital facility without an overnight hospital stay.
● Generic drugs – A drug that offers equivalent uses, doses, ● Primary Care Provider (PCP) – A doctor (generally
strength, quality and performance as a brand-name drug, a family practitioner, internist or pediatrician) who
but is not trademarked. provides ongoing medical care. A primary care physician
● Health Savings Account (HSA) – An HSA is a personal treats a wide variety of health-related conditions.
savings account for those enrolled in a High Deductible ● Reasonable & Customary Charges (R&C) – Prevailing
Health Plan (HDHP). You may use your HSA to pay for market rates for services provided by health care
qualified medical expenses such as doctor’s office professionals within a certain area for certain
visits, hospital care, prescription drugs, dental care, procedures. Reasonable and Customary rates may
and vision care. You can use the money in your HSA apply to out-of-network charges.
to pay for qualified medical expenses now, or in the ● Specialist – A provider who has specialized training
future, for your expenses and those of your spouse and in a particular branch of medicine (e.g., a surgeon,
dependents, even if they are not covered by the HDHP. cardiologist or neurologist).
● Health Reimbursement Arrangement (HRA) – A fund
you can use to help pay for eligible medical costs not
covered by your medical plan. Funds are contributed to
the HRA by the company.

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