Glossary

M

Managed Care

Managed care is the control of utilization, quality, and cost of medical care by using a variety of cost-containment methods, including the review of medical necessity, incentives to use certain providers, and case management.  Managed care may also be used as a general term for the activity of organizing doctors, hospitals, and other providers into groups in order to enhance the quality and cost-effectiveness of health care.

Related Terms: Cost Containment, Enhanced Provider Option, Health Maintenance Organization, Medically Necessary, Preferred Provider Option
Mandated Benefits

Mandated benefits are benefits that state or federal law requires employers to offer participants under a group health plan.  Mandated benefits vary from state to state and may be superseded by federal legislation, such as the Employee Retirement Income Security Act of 1974 (ERISA).

Related Terms: Benefit, Employee Retirement Income Security Act of 1974, Internal Revenue Code, Preemption of State Law
Medical Reimbursement Account — MRA

An MRA is an employer-funded account governed by IRS Notice 2002-45 that reimburses eligible uninsured health expenses and may be offered in conjunction with a qualified high-deductible health plan (HDHP).

Related Terms: Medical Flexible Spending Account
Medical Flexible Spending Account — FSA

A medical flexible spending account (FSA) is an employee-funded plan under which participants may obtain reimbursement for medical expenses that cannot be reimbursed through insurance or any other arrangement (e.g., co-payments, deductibles, eyeglasses, orthodontia).

Related Terms: Qualified Medical Expenses
Medically Necessary

The term "medically necessary" means a legal service, medicine, or supply that is usual and customary for the diagnosis and treatment of an injury or illness, is ordered by a physician or physician's assistant, is customarily recognized as being appropriate for treating the diagnosis, and is provided at an appropriate level of care to treat the injury or illness.

Related Terms: Covered Expenses, Usual and Customary
Medicare

Medicare is a federal health insurance program for people aged 65 and over, for persons eligible for social security disability payments for two years or longer, and for certain workers and their dependents who need kidney transplants or dialysis, without regard to financial status.  It consists of multiple programs, including Part A (i.e., hospital insurance), Part B (i.e., supplementary medical insurance), Part C (i.e., Medicare Advantage plans, which are health plans that are obtained through a private health insurance company that offers Medicare benefits), and Part D (i.e., prescription drug coverage).

Mental Health Parity

Mental Health Parity is a federal law that requires employers that have 50 or more employees and offer mental health benefits to have the same annual and lifetime limits for mental health benefits as for medical and surgical benefits.

Related Terms: Behavioral Care, Lifetime, Mandated Benefits
Motor Vehicle

A motor vehicle is a car or other vehicle, including a trailer, that has more than two wheels and is operated or designed for operation upon a public highway by power other than muscular power.  A motor vehicle does not include a motorcycle, a moped, or any off-road vehicle or all-terrain vehicle.

Related Terms: Motor Vehicle Exclusion
Motor Vehicle Exclusion

A motor vehicle exclusion prohibits the payment of benefits under a plan for injuries a covered person receives in an accident involving a motor vehicle.  Covered persons who fail to maintain motor vehicle insurance will not have any medical expense coverage for auto-related injuries under a health plan with a motor vehicle exclusion.  This exclusion does not apply to a covered person who is a Michigan resident involved in an accident outside the state of Michigan for which Michigan no-fault coverage is not legally available.  However, this exclusion does apply if a covered person is injured while in his or her own uninsured motor vehicle for which a Michigan no-fault policy is legally required and would have provided coverage, had such a policy been in effect.

Related Terms: Motor Vehicle
MRA

The term "MRA" means medical reimbursement account.

Related Terms: Medical Reimbursement Account