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Definitions of UHS Health Care Terms
Children: Dependent children can be covered on the Student Health Program until they turn 26 years old.
Coinsurance: Your percentage share for certain medical expenses after the deductible is met.
Copay or Copayment: The set dollar amount you pay for certain medical services.
COBRA: The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows extension of health insurance coverage for defined periods of time at your own expense providing application is made within 60 days of the termination of your appointment.
Deductible: The amount you must pay for services each annual plan year before the Student Health Program begins to pay for benefits. There is no deductible for prescriptions.
Domestic Partner: Two non-related adults of the same sex, both of whom are at least 18 years of age, are committed as a family in a long-term relationship of indefinite duration and are socially, emotionally, and financially interdependent in an exclusive mutual commitment in which they agree to be responsible for each other’s common welfare and share financial obligations. This definition covers same-sex partner relationships, and not persons who are cohabiting simply as roommates.
Johns Hopkins Employer Health Programs (EHP): Insurance provider for the Student Health Program.
Explanation of Benefits (EOB): An itemized statement that describes benefits processed by your insurance once medical services are provided.
Out-of-pocket Maximum: Since you are responsible for a portion of the cost of your medical expenses, the Student Health Program includes an annual plan year out-of-pocket limit to protect you in the event of high medical bills. After you have paid the out-of-pocket limit ($3,000 per person or $9,000 per family), the Student Health Program covers any additional medical expenses incurred in the same plan year at 100%. The out-of-pocket limit includes the deductible and coinsurance but does not include: penalties, prescription drug coinsurance and expenses, program maximums, or charges for services which are not covered.
Participating Provider: A physician, hospital, lab, etc. who has agreed to accept an EHP contractual amount as fee for service. Student Health Program participating providers are listed on the EHP website. The UHS Health Center is an EHP-participating provider.
Reasonable & Customary Charges (R&C): This is the usual fee charged by similar providers for the same services or supplies in the same geographic area. EHP determines what is reasonable and customary.
Spouse: One who is married to a student by a ceremony recognized by the law of Maryland. A husband or wife is a spouse until a court formally decrees the marriage to be dissolved.
Student Health Program (SHP): The student health insurance program administered through Johns Hopkins EHP.
Student Health Program Plan Year: The plan year runs from July 1 - June 30.
Summary Plan Description (SPD): Legal document outlining benefits provided under the Student Health Program.
University Health Services (UHS): A system of care which provides health services to eligible students, house staff, postdoctoral fellows, trainees and dependents in the Johns Hopkins School of Medicine, the Berman Institute of Bioethics, the Bloomberg School of Public Health and the School of Nursing. UHS includes primary care, mental health and wellness services, as well as the UHS Benefits Office.
UHS Benefits Office: The UHS Benefits Office assists you with billing and benefits inquiries and makes payments to approved providers for eligible medical services rendered.
UHS Health Clinic: The adult primary care center for eligible participants and adult dependents providing medical care, referrals to specialists, and mental health care.
UHS Health Fee: An annual fee assessed to all full-time students and trainees in the Johns Hopkins University School of Medicine, the Berman Institute of Bioethics, the Bloomberg School of Public Health, and the School of Nursing for access to the services provided by UHS.