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Gatekeeper: Refers to the primary care physician who will determine an individual's path or access to treatment. The primary care physician may treat or refer the patient on to a specialist or other healthcare services.
Gatekeeper Model: The network arrangement that features a primary care physician as its gatekeeper. The gatekeeper treats patients initially or refers to them to specialists for coordinated care.
Gatekeeper Question: Refers to the qualifying questions an insurance company will ask a person to identify their health risks.
Generic Drug: The chemical equivalent of a brand-name drug whose patent has expired. Typically, a generic drug costs less than the brand-name option.
Generic Equivalent: See Generic Drug.
Generic Substitution: A generic substitution is made when a chemical equivalent to a brand-named drug is dispensed in its place. Many state regulations inform drug substitution guidelines.
Grace Period: Refers to the set number of past due days by which an unpaid premium amount may remain unpaid without incurring cancelation of the policy. This period varies in accordance with insurance providers and insurance plans. A typical grace period may be 30 to 60 days.
Grievance: An issue or concern with a product or services that a customer formally expresses.
Group: Refer to batched individuals who are treated by an employer as a single entity, usually in reference to health insurance coverage.
Group Policy / Contract: The document and its associated addenda that specifies the group's health benefits, exclusions, and all other contracted conditions made between the enrolling group and the insurer.
Group Model HMO: A type of healthcare model that involves organized physicians who deliver healthcare to a network at a negotiate rate. The group is responsible for payment to doctors and participating hospitals for patient care.
Group Practice without Walls: Refers to a network of physicians who have legally formed a single entity while still maintaining their own practices. Each site retains a degree of autonomy, but the assents are acquired by the umbrella entity.
Guaranteed Issue Underwriting: Refers to situations when an applicant is guaranteed coverage up to a set amount regardless of insurability status.
Guaranteed Renewable: Refers to an insured individual's right to continue their active policy in association with their timely premium payments. Insurance companies may not refuse to renew the policy for anything other than non-payment.