Under the Health Insurance Portability and Accountability Act (HIPAA), this phrase refers to the tasks (functions) of a covered entity, the performance of which makes the entity a health plan, health care provider, or health care clearinghouse.

Total of insured members of a managed care plan or individual or group insurance plan.

1. Specific health care services and supplies for which the insurance plan or federal or state program will provide reimbursement for covered persons under the terms of the plan; these consist of a combination of mandatory and optional services stated in each plan. 2. Services for which supplemental medical insurance (SMI) pays, as defined and limited by statute. Covered services include most physician services, care in outpatient departments of hospitals, diagnostic tests, durable medical equipment, ambulance services, and other health services that are not covered by the hospital insurance program. Also called coverage or covered expenses.

Person who has earnings creditable for Social Security purposes on the basis of services for wages in covered employment and/or on the basis of income from covered self-employment. The number of hospital insurance covered workers is slightly larger than the number of Old Age, Survivors, and Disability Insurance (OASDI)–covered workers because of different coverage status for federal employment.