Covered medical services a managed care plan or government program offers to individuals or to groups. In addition to physician and hospital services, some insurance policies have coverage for acupuncture, alternative therapies, assisted living care, chiropractic care, dental, drugs, home nursing care, skilled nursing care, and vision care. Also called approved services, benefit plan, benefits , and health benefits package .

List of fees, sometimes with procedural code numbers of the services, and description of the services that an insurance plan will pay and are covered under the managed care plan or insurance policy. Also known as schedule of benefits, table of allowances, fee schedule, fee allowance, fee maximum , or capped fee .

Amounts disbursed for covered services to beneficiaries after the deductible and coinsurance amounts have been deducted.

1. Time period for which benefits are payable under an insurance contract without a new deductible requirement. These effective dates of coverage can be a designated 6-month period, calendar year, or a plan’s anniversary date. Also called spell of illness . 2. Period of time for which payments for Medicare inpatient hospital benefits are available. A benefit period begins the first day an enrollee is given inpatient hospital care (nursing care or rehabilitation services) by a qualified provider and ends when the enrollee has not been an inpatient for 60 consecutive days. Patient must pay the hospital insurance deductible for each benefit period. 3. In workers’ compensation cases, the maximum amount of time that benefits will be paid to the injured or ill person for the disability.
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Commonly disability insurance is has benefit periods of 2 or 5 years, to age 65, or, in some cases, life. Since the chances of becoming disabled are much more for a person 40 years old than the chances of dying and the average length of disability is 3.2 years, the selection of a proper benefit period is important.

Insurance contract that provides hospital, surgical, medical, or other health coverage; also called benefit contract .
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See: benefit package and certificate of coverage (COC) .

Phrase used by insurance companies and managed care companies that refers to the types of insurance plans they offer; also used as a synonym for benefits .

Health care service explained in detail that the insurance company agrees to pay to a claimant, assignee, or beneficiary under a health insurance policy or contract.

Under a group insurance plan, a table that lists the amount of coverage given to each class of insured and may show earnings and job position. Also known as benefit payment schedule, schedule of benefits, table of allowances, fee schedule, fee allowance, fee maximum , or capped fee .

Official document from the Social Security Administration that provides information on how much an individual receives in monthly Social Security benefits and/or Supplemental Security Income payments. A letter is normally issued after a request from a beneficiary or his or her authorized representative.