Insurance company that accepts certain types of risks considered uninsurable according to the insurer’s normal underwriting guidelines.

A document or voucher detailing services billed and describing payment determinations that is sent to the insured and provider. It is known in Medicare, Medicaid, and some other programs as a remittance advice (RA) ; formerly known as Explanation of Medicare Benefits (EOMB) . In the TRICARE program, it is called a summary payment voucher . A payment check is usually attached or a part of the EOB. The EOB should include details of the claim(s) submitted, payment(s), deductible status, and each insured’s responsibility to the provider. See also electronic remittance notice (ERN), remittance advice (RA) , and Medicare remittance notice (MRN) .

Insurance booklet or section in the insurance policy that summarizes provisions (benefits and coverages) under an insurance policy. Also called a benefit booklet, benefit plan summary , or summary plan description .

Additional information about items referenced by footnotes or symbols on an explanation of benefits (EOB) document.

Verbal or written agreement.

To carry forward the balance of an individual ledger.

1. Insurance coverage of more than basic health plans. 2. Insurance policy provision that extends coverage for a certain time period after termination of benefits. Also called extended insurance . 3. Allows medical coverage to continue past termination of employment. See also Consolidated Omnibus Reconciliation Act of 1985 (COBRA) .

Long-term inpatient care in a skilled nursing facility (SNF) or convalescent or nursing home, rather than a hospital. Frequently patients who are recovering after hospitalization are sent to SNF. Also known as convalescent care .

Insurance policy provision that covers room and board charges in an extended care facility (ECF). It is stated similar to that for hospital room and board.