Glossary: O

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Occupational injury/diseaseThis is an injury or disease caused by doing a job. In most states, this is covered by workers' compensation.
Occupational therapy People can lose some skills because of an accident or illness. These skills include walking, eating, drinking, dressing and bathing. This treatment helps restore the skills.
Open accessSome health plans let members see a participating provider without a referral. In other words, they give “open access.” This might be called direct access.
Open enrollment People make choices about their health plan coverage during this period. Their choices are for coverage in the next year.
Open formularySome prescription benefits plans cover all eligible prescription drugs. This means they have an “open formulary.” In these plans, people might have lower copays for drugs on the preferred drug list. They might have higher copays for drugs that are not on this list.
Optimum This means most favorable or best.
OralThis means by mouth.
Oral and maxillofacial surgeon This dental surgeon treats in and around the inside of the mouth and jaws.
Original containerThis is the bottle or box something comes in.
Original Medicare plan See Medicare Part A and Medicare Part B.
OrthodontistThis is a type of dental specialist. This specialist finds, prevents and corrects problems in how teeth are positioned in the jaws.
Osteoporosis This is a medical condition. A person with this condition has soft, brittle bones.
Other income benefitsDisability plans provide a source of income for people who cannot work because of illness or injury. These are called income benefits. Income from other sources may reduce payments made under the plan. These are called other income benefits. (They are also called “offsets” and “reductions.”) Social Security Disability and workers' compensation are two examples. See “Minimum benefit” and “Social Security Disability.”
Out of networkThis means that we do not have a contract for reduced rates with a doctor. We don't know exactly what an out-of-network doctor will charge you.

If you choose a doctor or other health care provider who is out of network, your Aetna health plan may pay some of that doctor's bill. But it will pay less than if you get care from a doctor in our network.  You will pay more money if you decide to use a doctor that is not in our network.

Check your plan documents for more details: Your health plan documents will tell you how we pay for out-of-network care. Or call Member Services at the phone number listed on your Aetna ID card. Learn More
Out-of-pocket costs These are medical costs that a member must pay. Copays and deductibles are examples.
Out-of-pocket maximumThis is a limit on the costs a health plan member must pay for covered services. The limit can be yearly or a dollar amount.
Outpatient care This is care a person gets in a clinic, emergency room, hospital or surgery center. The person gets the care and goes home. There is no overnight stay.
Outpatient procedureSome procedures can be done in a hospital, surgery center or doctor’s office. The person gets it done and goes home. There is no overnight stay. This is also called “ambulatory surgery.”
Over-the-counter drugs These are drugs that can be bought without a prescription. They are not covered under most prescription benefits plans.

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