Health Insurance Glossary - M Terms
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M
Major Medical Insurance
Health insurance that provides coverage for major and catastrophic medical care, often with a high deductible. Some restrictions may apply, such as the requirement to obtain prior authorization for hospital treatment or other high-cost services.
Managed Care
A system of providing healthcare services that deliver the most optimal patient care in the most cost-effective manner through monitoring, review and recommendation of services rendered.
Mandated Benefit
Specific coverage an insurer must include in an insurance policy under law. For example, most states require that all health insurance contracts provide coverage for treatment for substance-abuse.
Material Misrepresentation
A false statement or an omission regarding an important fact made by an individual in an insurance application or claim.
Maximum Dollar Limit
A specified maximum amount an insurer will pay for covered health care costs during a specified period. A limit may be imposed on a particular procedure or service, and/or on the total aggregate amount of covered health care costs.
Maximum Lifetime Benefit
A specified maximum amount an insurer will pay for covered health care costs during the lifetime of the insured. A limit may be imposed on a particular procedure or service, and/or on the total aggregate amount of covered health care costs.
Medicaid
A program sponsored by the government that provides health care to individuals and families with low-income and resources. The program is jointly funded by the government and the states, and managed by the states.
Learn more about Medicaid.
Medicare
A health insurance program administered by the government for people who are aged 65 and older, or who meet other special criteria. Medicare is partially funded by payroll taxes.
Learn more about Medicare.
Medicare Supplement Insurance
Additional health insurance coverage obtained from a private insurance company to cover some health care costs not covered by Medicare. Also known as Medigap Insurance.
Medigap Insurance
Additional health insurance coverage obtained from a private insurance company to cover some health care costs not covered by Medicare. Also known as Medicare Supplement Insurance.
Multiple Employer Trust (MET)
A trust formed by two or more small employers in the same industry for the purpose of obtaining group health insurance for employees at a lower cost than each employer or employee could obtain individually.
Mutual Insurance Company
An insurance company that does not have public stock and is wholly-owned by its policyholders.
September 7, 2010
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