Formulary: This is the list of services, medications and supplies your insurance covers.
In-Network: These are the providers, suppliers and facilities your insurance covers.
Out-of-Network: These are providers, suppliers, and facilities your insurance does not cover, or only covers partially.
Emergency Room: The 24-hour department of a hospital that provides care for life-threatening emergencies. Same as Emergency Department or ED.
Urgent Care: The clinic or hospital department that provides care without an appointment when you are sick or injured. Often called a Walk-In Clinic.
Generic Medication: The least expensive form of a medication, often referred to as the active ingredient. Example: Ibuprofen (same drug as name brand Motrin).
Brand Name Medication: The manufacturer’s trademark name of medication. Example: Motrin (same drug as Ibuprofen)
Referral: This is the formal process through which your health care provider asks your insurance company to cover your visits with a specialist, and asks that specialist to participate in your care.