Terms Used In Ohio Code 1751.17

• Basic health care services: means the following services when medically necessary:

  (a) Physician's services, except when such services are supplemental under division (B) of this section;

  (b) Inpatient hospital services;

  (c) Outpatient medical services;

  (d) Emergency health services;

  (e) Urgent care services;

  (f) Diagnostic laboratory services and diagnostic and therapeutic radiologic services;

  (g) Diagnostic and treatment services, other than prescription drug services, for biologically based mental illnesses;

  (h) Preventive health care services, including, but not limited to, voluntary family planning services, infertility services, periodic physical examinations, prenatal obstetrical care, and well-child care;

  (i) Routine patient care for patients enrolled in an eligible cancer clinical trial pursuant to section 3923. See Ohio Code 1751.01

• Child: includes child by adoption. See Ohio Code 1.59
• Contract: A legal written agreement that becomes binding when signed.
• Corporation: means a corporation formed under Chapter 1701. See Ohio Code 1751.01
• Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
• Dependent: A person dependent for support upon another.
• Enrollee: means any natural person who is entitled to receive health care benefits provided by a health insuring corporation. See Ohio Code 1751.01
• Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
• Health care services: means basic, supplemental, and specialty health care services. See Ohio Code 1751.01
• Health insuring corporation: means a corporation, as defined in division (H) of this section, that, pursuant to a policy, contract, certificate, or agreement, pays for, reimburses, or provides, delivers, arranges for, or otherwise makes available, basic health care services, supplemental health care services, or specialty health care services, or a combination of basic health care services and either supplemental health care services or specialty health care services, through either an open panel plan or a closed panel plan. See Ohio Code 1751.01
• Premium rate: means any set fee regularly paid by a subscriber to a health insuring corporation. See Ohio Code 1751.01
• state: means the state of Ohio. See Ohio Code 1.59
• Subscriber: means a person who is responsible for making payments to a health insuring corporation for participation in a health care plan, or an enrollee whose employment or other status is the basis of eligibility for enrollment in a health insuring corporation. See Ohio Code 1751.01
• Supplemental health care services: means any health care services other than basic health care services that a health insuring corporation may offer, alone or in combination with either basic health care services or other supplemental health care services, and includes:

  (a) Services of facilities for intermediate or long-term care, or both;

  (b) Dental care services;

  (c) Vision care and optometric services including lenses and frames;

  (d) Podiatric care or foot care services;

  (e) Mental health services, excluding diagnostic and treatment services for biologically based mental illnesses;

  (f) Short-term outpatient evaluative and crisis-intervention mental health services;

  (g) Medical or psychological treatment and referral services for alcohol and drug abuse or addiction;

  (h) Home health services;

  (i) Prescription drug services;

  (j) Nursing services;

  (k) Services of a dietitian licensed under Chapter 4759 of the Revised Code;

  (l) Physical therapy services;

  (m) Chiropractic services;

  (n) Any other category of services approved by the superintendent of insurance. See Ohio Code 1751.01

• United States: includes all the states. See Ohio Code 1.59