Glossary: A

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Accelerated death benefit (ADB)This can help people who have a fatal illness. The member or spouse can get some life insurance benefits as an early payment.
Accidental Death and Dismemberment (AD& D) This benefit can be paid in two ways. It can be paid to the insured person after an accidental injury. Or, it can be paid to someone else after the death of an insured person.
Accidental Death and Personal Loss (AD& PL) or AD& D Ultra® This benefit covers the same losses as AD& D. It also pays for other unexpected events. Such events could cause loss of sight, speech or hearing. In case of death, benefits may be used for education, child care and other services.
Accreditation This is proof that a health plan or hospital meets certain standards. An outside group decides this through an official review.
Active full-time employeeThis is a person who works a normal workweek for an employer. Employees must work at least the number of hours shown in a plan's Schedule of Insurance.
ADA See “Americans with Disabilities Act.” 
ADBSee “Accelerated death benefit.” 
AD&D See “Accidental Death and Dismemberment.” 
ADEASee “Age Discrimination Employment Act.” 
Adjudication This is the way health plans decide how much they will pay for certain expenses.
Adjusted pre-disability earningsA long-term disability plan provides a source of income if you cannot work because of illness or injury. This helps you maintain a percentage of what you earned before you became disabled. Adjustments are made over time to help protect against inflation. Example: A disability plan pays 60% of your salary. You earned $50K before you become disabled at age 40. With no adjustment to your income, inflation would greatly reduce your buying power by the time you reached age 60.
AD&PL See “Accidental death and personal loss coverage.” 
Advance directiveThis legal document tells your doctor what kind of care you want or do not want. It will be used if you are too sick to make medical decisions on your own. It is sometimes also called a “living will.” Learn More 
Aetna HealthFund® This is the name used for Aetna's consumer-directed health products. Each one comes with different types of funds to help members pay for their care. These funds are Health Reimbursement Arrangement (HRA), Health Savings Account (HSA), Retiree Reimbursement Account (RRA), Flexible Spending Account (FSA) and the First Dollar Plan.
Aexcel®Aetna uses this mark for some specialist doctors. These doctors have met certain performance levels for their medical care and cost. 7.0
Age Discrimination Employment Act (ADEA) This is a U.S. law. It protects people against unfair treatment in the workplace due to age.
Alcohol & drug restriction or limitationThis limits the length of time benefits will be paid. It applies to treatment for disabilities due to alcohol or drug abuse.
Allowable expense(s) This is the part of a bill that is eligible to be paid under your health plan.
Allowed amountA limit on the amount your health plan will pay.  Also called the "recognized charge."  If you choose to go out of network, your provider may not accept this amount as payment in full and may bill you for the rest. This is in addition to your plan's required co-pays and deductibles.

Check your plan documents for more details: Your health plan documents will tell you how we pay for out-of-network care and how we calculate the allowed amount.  Or call Member Services at the phone number listed on your Aetna ID card. Learn More 
AmalgamThis is a type of filling made up of several different metals. It is silver in color and is mainly used on back teeth.
Ambulatory care See “Outpatient care.” 
Ambulatory surgerySee “Outpatient procedure.” 
Americans with Disabilities Act (ADA) This law protects the rights of people with disabilities. It helps prevent them from being treated unfairly on the job.
Ancillary servicesThese are services provided to support your health care. Some examples include X-rays or lab tests.
Annual coordinated election period (AEP) This is a time when you can make changes to your Medicare plan. It runs from November 15 through December 31 each year.
Any occupationThis is any type of job for which a person is qualified. A person can do the job because of schooling, training or experience.
Appeals process This process lets you ask for a review of claims that have been denied by your health plan.
AuthorizationSee “Precertification.” 

Legal Notices