1. Health benefit insurance policy that offers minimal coverage for medical expenses under a specific level such as $10,000 a year but gives coverage for severe and prolonged chronic illness or injury that may cause the patient difficult financial hardship. Generally there is no maximum amount of coverage for this type of plan, but there may be some coinsurance. 2. Under a Medicare Part D plan, the name for the step in which the plan pays nearly all of the patient’s drug expenses until the end of the year, with no upper limit. The patient pays only a small share of the drug expenses (approximately 5%). Also called catastrophic insurance, catastrophic health insurance, catastrophic plan, or major medical.

Medical services for a patient who has suffered a severe injury or has a long-term illness that may substantially diminish a family’s income and resources.

Severe injury or illness that has very large expenses and for which the patient must be treated long term.

Highest amount of money the patient must pay out of pocket during a certain period of time for specific covered charges. When obtaining health insurance, setting a maximum amount protects the insured.

1. Specific geographic area in which a managed care plan enrolls its members. 2. In the TRICARE program, a certain region defined by ZIP codes that is approximately 40 miles in radius surrounding each U.S. military treatment facility. Also called service area.