Glossary of Terms

P

Personal Health Record (PHR)

The Personal Health Record is a secure, online tool that connects people to their health information by offering a convenient, easy way to store their health history and information so it is organized and available when needed. Members can share PHR information with their health care providers and stay prepared for many health-related needs that may arise―from making it easier to fill out medical forms to accessing health data in an emergency.

Price-a-Medication Tool

The Price-a-Medication Tool is an online tool available at Medco’s prescription drug web site. This tool lets you look up your medication and its cost, and search for lower-cost alternatives that may be available and appropriate for you.

Participating Retail Pharmacy

A participating retail pharmacy is a retail pharmacy that has contracted with Express Scripts to provide prescription drug services to LM HealthWorks Plan members. Express Scripts is Lockheed Martin’s prescription drug benefit provider.

Preferred Brand-name Drug

A preferred brand-name drug is one that is listed on the plan’s formulary or preferred list of prescription drugs.

Preferred Drug List

The Preferred Drug List, or formulary, is a list of brand-name and generic medications that are preferred by your prescription program. The Preferred Drug List contains a very broad list of medications for most medical conditions that are treated on an outpatient basis. Because the medications on the list are preferred, you will usually pay a lower coinsurance than you would for non-preferred drugs.

Prescription Drug

A prescription drug is one that you can get only with an order form (prescription) from your doctor or health care professional.

Preventive Care

Preventive care is the name given to health care services that help you stay healthy or help detect early signs of disease. Examples include routine physicals, immunizations, well-child and well-woman care, and cancer screenings. The LM HealthWorks Plan typically pays 100% for covered preventive care services. The annual deductible and out-of-pocket maximum do not apply.

Primary Care Physician

A primary care physician (PCP) is a doctor who provides routine and basic care. The LM HealthWorks Plan does not require you to choose a PCP and does not require referrals from a PCP for specialty care. However, you may want to consider using a PCP for the care coordination and continuity that he or she can provide.

Proof Of Insurability

Proof of insurability (POI) is the process an insurance company uses to determine that you are insurable. You may have to provide a statement of your health history and may also be asked for other evidence of good health, such as a medical examination. You may be asked to pay for some of the costs associated with this process.

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