Patient access glossary
The access questions your patients bring.
Coverage turns on vocabulary most patients are never taught. Each term is defined against its cited public source, with what patients ask your team about it and how OpenSupport answers.
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Biosimilar
A biological medicine highly similar to an approved reference product, with no clinically meaningful differences from it.
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Coverage appeal
A formal request asking a health plan to reconsider a coverage denial.
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Explanation of benefits (EOB)
A statement from a health plan showing what a claim covered and what the patient may owe. It is not a bill.
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Formulary tier
The cost-sharing band a health plan assigns a medicine on its list of covered drugs.
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Prior authorization
Approval a health plan requires before it will cover a specific medicine, test, or procedure.
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Step therapy
A plan rule requiring a patient to try a plan-preferred medicine first before a different one is covered.
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