Vocabulary List

We want our members to be informed and empowered.

Use our fact sheet to get comfortable with some commonly used healthcare terms, check back whenever you need a refresher!
A type of Medicare health plan that contracts with Medicare to provide you with all your Part A and Part B benefits. eternalHealth’s Medicare Advantage plan also includes Part D (your prescription drug plan) as well as additional wellness benefits.
If you’re not covered by an employer or qualified for Medicare or Medicaid, then you can apply directly for health insurance. We offer exchange plans that give you all the right benefits for low premiums and out of pocket costs.
Plans that offer a specific network of physicians, provide integrated care and often focus on prevention and wellness.
The health care items or services covered under your insurance plan
A fixed amount that you pay for a covered health service once you’ve paid your deductible.
The percent (for example, 20%) you pay of the allowed amount for covered health care services to your providers.
The maximum amount that your plan covers for that specific service.
The monthly amount that you pay for your health insurance plan

The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.

After you pay your deductible, you’re only responsible for the appropriate co-payment.

A request for payment that you or your health care provider submits to your health insurer when you get items or services
The providers that are included within the plan’s specific network.
The statistical process that takes into account underlying health conditions to provide insurers with information about potential healthcare costs. eternalHealth works closely with your physicians to ensure that these risk adjustments are made to provide you with optimal care.
Ratings of health insurance plans used in the Health Insurance Marketplace, on a scale of 1-5. This helps you pick the best quality plan for you.
Integrated care approach that includes screening, check-ups, and coordinating your care. eternalHealth’s chronic care management programs improve quality of life while reducing future healthcare costs.
Traditional healthcare that focuses on specific medical episodes and lacks the patient and provider engagement that truly improves future health.

This portion of your care includes screenings, check-ups and counseling to prevent health problems before they happen.

To prevent those flare-ups, continuing issues or potential high-cost hospital visits, our at-home tools help you take the medication you need, when you need it. And our value-based care ensures you get the prescriptions you need, no more, no less.

Our platform lets your different healthcare providers organize your treatment. We take on the logistics, so you don’t have to.

Our benefits, including gym memberships, diabetes management programs, and preventative screenings, improve your health and fitness, even before the doctor’s office.

Page Last Updated On: February 13, 2023
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Tom Cunniffe

Tom Cunniffe

Director of Operations 

Tom Cunniffe comes to eternalHealth with over 20 years of healthcare operations’ experience, having held leadership positions in Call Center, Enrollment, Credentialing, UAT and Reimbursement teams. Tom has worked with Medicaid, Commercial and Medicare lines of business and has consistently built teams who are metrics driven with proven successful outcomes. Making sure our business strives for an efficient, best-in-class customer experience is at the center of Tom’s philosophy.

Tom has a bachelor’s degree from Fordham University and a master’s in business administration from University of Massachusetts at Amherst.

Tom Lawless

Tom Lawless

Chief Financial Officer

Tom Lawless has spent the past 20+ years building, sustaining, and growing new healthcare-related programs that balance fiscal responsibility & prudence with creativity & innovation, focusing on models of care that are novel, person-centered, and improve the social welfare of those who are served. He is very excited to continue doing so in his role as the Chief Financial Officer of eternalHealth.

Tom comes to eternalHealth from a not-for-profit, member-centric, health insurance cooperative. He helped the company continuously strive toward its dual goals of thriving financially, while keeping members at the very epicenter of its mission and service model. While there, Tom also spearheaded the creation of a brand new private, charitable foundation, which will be meaningfully giving back to those in need in the surrounding communities for years to come. Previously, Tom worked in the finance department of a successful hospice that provided high-quality care to persons experiencing their unique and poignant end-of-life journeys, assuring that the appropriate financing was always available. Tom’s career began as a civil servant in the Wisconsin Medicaid program, where he helped to create a program that expanded the institutional entitlement to care into home and community-based settings. Starting with only a blueprint in hand, the program now serves more than 57,000 frail elders and disabled adults and is considered a national model. Growing into a senior leadership role, Tom was a key architect of an innovative financing model, through which the public and private sectors successfully collaborated to better the lives of persons in great need.

Tom holds undergraduate and graduate degrees from the University of Chicago, with additional graduate work in economics completed at the University Wisconsin-Madison.

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