F
Family Coverage
An Individual/Family Medical Plan is renewable for multiple years and provides continuous claims coverage. Most healthcare companies offer comprehensive major medical plans that cover both major medical expenses (e.g., hospitalization and surgeries) and routine medical expenses (e.g., office visits and annual exams). In addition, they typically offer a variety of plan types to choose from, such as PPOs, HMOs and POSs.
fee schedule payment structure
A fee structure used by insurers under which the insurance company places caps or limits on the dollar amounts that it will reimburse providers covered medical procedures and services, both in and out-of-network if applicable. Also known as a limited fee schedule.
fee-for-service plan
Also called an indemnity plan. A health insurance plan that allows the insured to use any medical provider that he or she chooses. As such, there are no networks to utilize.
flex-term medical coverage
See "short-term medical coverage."
formulary drugs
Formulary drugs generally have a lower copay. A formulary drug is one that has been thoroughly reviewed by a team of expert pharmacists and physicians; these drugs have been identified as safe, effective and beneficial to members for treating medical conditions. When deciding between drugs which are equally safe and effective, the formulary team also considers the relative costs of medications. These savings are then passed on to you through lower premiums.
fully insured plan
A group insurance plan for which an insurance company bears the responsibility of making all claim payments.
fully self-insured plan
A group insurance plan under which the employer takes complete responsibility for all claim payments and related expenses rather than purchasing coverage from an insurance company.
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