Health Insurance Glossary
- Lab/X-Ray:
- Typically, lab/x-ray is any diagnostic lab test or diagnostic/therapeutic x-ray performed in support of basic health services. Lab services typically include services like blood panels and urinalysis. X-ray services typically include basic outpatient skeletal or other plain film x-ray, outpatient ultrasound, GI series, MRI, and CT scan. Prostate cancer screening, mammograms, and pap smears may be covered by Lab/X-Ray benefit, or they may be covered by Periodic OB-GYN benefit or Preventative Care benefits. Typically, dental x-rays are not included in Lab/X-ray benefits.
- Lapse:
- The termination of insurance coverage due to lack of payment after a specific period of time.
- Length of Stay (LOS):
- The total number of days that a patient stays in a facility such as a hospital.
- Lifetime Limit:
- Many health insurance plans place dollar limits upon the claims that the plan will pay over the course of an individual's life. PPACA prohibits lifetime limits on the dollar value of benefits deemed essential by the Department of Health and Human Services, for plan or policy years beginning on Sept. 23, 2010.
- Lifetime Maximum:
- Lifetime maximum or lifetime limits refers to the maximum dollar amount that a health insurance company agrees to pay on behalf of a member for covered services during the course of his or her lifetime. For plan or policy years beginning on or after Sept. 23, 2010, plans may not establish any lifetime limit on the dollar amount of benefits for any individual. All plans are required by PPACA to remove the lifetime maximum restrictions.
- Limitations:
- A term referring to any maximums that a health insurance plan imposes on specific benefits.
- Long-term Care:
- Care provided on a continuing basis for the chronically ill or disabled. Long-term care may be provided on an inpatient basis (at a long-term care facility) or in the home setting.
please note, however, that definitions of certain terms may vary across insurance companies.
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