Stop-Loss

A general term referring to that category of coverage that provides insurance protection (reinsurance) to an employer for a self-funded plan.

Medically Necessary Care

ALL A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
The reasonable and appropriate diagnosis, treatment, and follow-up care (including supplies, appliances and devices) as determined and prescribed by qualified, appropriate health care providers in treating any condition, illness, disease, injury, or birth developmental malformations. Care is medically necessary for the purpose of: controlling or eliminating infection, pain, and disease; and restoring facial configuration or function necessary for speech, swallowing or chewing.