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In contract law, a severable contract (or "divisible contract") is a contract that is composed of several separate contracts concluded between the same parties, such that failing one part of such a 'severable' contract does not breach the whole contract. Therefore, the other party must still honor the other subparts and cannot cancel the whole ...
Guaranteed issue is a term used in health insurance to describe a situation where a policy is offered to any eligible applicant without regard to health status. Often this is the result of guaranteed issue statutes regarding how health insurance may be sold, or to provide a means for people with pre-existing conditions the ability to obtain health insurance of some kind.
The University of Pittsburgh Medical Center defines a pre-existing condition as a "medical condition that occurred before a program of health benefits went into effect". [1] J. James Rohack, president of the American Medical Association , has stated on a Fox News Sunday interview that exclusions, based upon these conditions, function as a form ...
National Federation of Independent Business v. Sebelius, 567 U.S. 519 (2012), is a landmark [2] [3] [4] United States Supreme Court decision in which the Court upheld Congress's power to enact most provisions of the Patient Protection and Affordable Care Act (ACA), commonly called Obamacare, [5] [6] and the Health Care and Education Reconciliation Act (HCERA), including a requirement for most ...
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
The Pre-existing Condition Insurance Plan (PCIP) was a form of health insurance coverage offered to uninsured Americans who were unable to obtain coverage because of a pre-existing condition. These provided coverage to as many as 350,000 people to fill the gap until the Affordable Care Act went into effect in 2014. The plan was funded by ...
Your medical condition must be long-term to qualify for Social Security disability benefits. Additionally, you must have worked in a job covered by Social Security – most Americans between the ...
Structural definitions of insurance, generally consider both the type of benefits that are offered by the healthcare insurance program, as well as the number and range of providers whose services are covered under the identified plan. A structural approach to defining underinsurance uses a benchmark benefits package as a basis of comparison.