US Medical Term · insurance
Level of Care
Nivel de atención
In 9 languages
| Language | Term |
|---|---|
| English | Level of Care |
| Spanish (Español) | Nivel de atención |
| Chinese (中文) | 照護級別 |
| Korean (한국어) | 치료 수준 |
| Vietnamese (Tiếng Việt) | Mức độ chăm sóc |
| Filipino (Tagalog) | Antas ng pangangalaga |
| Portuguese (Português) | Nível de cuidado |
| Thai (ภาษาไทย) | ระดับการดูแลรักษา |
| Japanese (日本語) | ケアレベル |
What it means
Level of care refers to the intensity and type of medical or behavioral health services a patient needs, ranging from primary preventive care to emergency or intensive care. Insurance plans use level-of-care criteria — often based on clinical guidelines — to determine whether the setting and intensity of treatment is medically appropriate and eligible for coverage. Common levels include outpatient, intensive outpatient, partial hospitalization, and inpatient. If an insurer determines care is at a higher or lower level than necessary, it may deny part of the claim. Utilization review teams assess level of care during prior authorization and concurrent review.
How to say it
Sentences a patient might use with a doctor, nurse, pharmacist, or insurer:
My doctor recommended inpatient treatment — will my insurance cover that level of care?
Mi médico recomendó tratamiento hospitalario — ¿cubrirá mi seguro ese nivel de atención?
What criteria does my plan use to determine the appropriate level of care?
¿Qué criterios utiliza mi plan para determinar el nivel de atención apropiado?
My claim was denied because the level of care was deemed unnecessary — how do I appeal?
Mi reclamación fue rechazada porque se consideró innecesario el nivel de atención — ¿cómo apelo?
Where you'll see it
Related terms
Sources
Last reviewed: September 2026