Health Insurance Glossary
- National Association of Insurance Commissioners (NAIC):
- The NAIC is a national association of state officials charged with regulating insurance. The NAIC was formed to help provide some measure of national uniformity in insurance regulation.
- National Drug Code (NDC):
- A system employed by healthcare providers and insurance companies for classifying and identifying drugs. Each prescription drug in common use is assigned an NDC number.
- Network:
-
A "Network" plan is a variation on a PPO plan. With a Network plan you'll need to get your medical care from doctors or hospitals in the insurance company's network if you want your claims paid at the highest level. You will probably not be required to coordinate your care through a single primary care physician, as you would with an HMO, but it's up to you to make sure that the health care providers you visit participate in the network. Services rendered by out of network providers may not be covered or may be paid at a lower level.
- A Network plan may be right for you if:
-
- Your favorite doctor already participates in the network (use our
- Doctor Finder
- tool to find out)
- You want some freedom to direct your own health care but don't mind working within a network of preferred providers
- Your favorite doctor already participates in the network (use our
- Network Provider:
- A healthcare provider who has a contractual relationship with a health insurance company. Among other things, this contractual relationship may establish standards of care, clinical protocols, and allowable charges for specific services. In return for entering into this kind of relationship with an insurance company, a healthcare provider typically gains in numbers of patients and a primary care physician may receive a capitation fee for each patient assigned to his or her care.
- Non-duplication of Benefits:
- -see, COB.
- Nursing Home:
- A licensed facility which provides general nursing care to those who are chronically ill or who require constant supervision and assistance with the needs of daily living.
please note, however, that definitions of certain terms may vary across insurance companies.
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