Health Insurance Definitions What The Terms Mean

Benefit Period - When services are covered under your plan. Different from group plans which are.

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A health insurance program that offers eligible employees and their dependents extended health insurance coverage for the plan theyre on in the event that they lose their job or their hours are reduced.

Health insurance definitions what the terms mean. This excludes accidental illness surgical procedures pregnancy injury or illnesses induced by alcohol or drug dependence and aggravation of a pre-existing condition. Please further note that definitions and plan options may vary by state and plan. The key to understanding health Insurance is to become an informed consumer by knowing its definitions terms and conditions before you plan to buy it.

Health care services or supplies needed to prevent diagnose or treat an illness injury condition disease or its symptoms and that meet accepted standards of medicine. 14 2014 at 800 am. It stands for the C onsolidated O mnibus B udget R econciliation A ct of 1985 which is the law that first introduced COBRA insurance.

Items that may be considered in the rating process include age sex type of industry benefits and administrative costs. For example your health insurance may cover 70 of the charges for a covered hospitalization leaving you responsible for 30. Health insurance is insurance against the risk of incurring medical expenses among individuals.

A bodily injury sustained as a result of unintentional unforeseen unexpected actions or events that require treatment by a registered medical practitioner at a hospital. What Is Health Insurance. It also defines the time when benefit maximums deductibles and coinsurance limits build up.

-see Usual Customary and Reasonable UCR Charge. An individual can avail such a policy against monthly or annual premium payments for a specified tenure. Health insurance is a type of insurance coverage that typically pays for medical surgical prescription drug and sometimes dental expenses incurred by the insured.

27 rows Nov. Reasonable and Customary Charges. Health insurance definitions.

A licensed health care facility program agency doctor or health professional that contracts with a health plan to deliver health care services to plan members. To a collective bargaining agreement other than a State-licensed insurance company or HMO that provides health insurance benefits to the employees of two or more private employers. Some insurance companies also offer a 5 per cent discount in.

Allowed Amount - The highest amount we will cover pay for a service. Scroll to the very bottom for terms and definitions specifically related to Health Life Insurance. A condition in which as the result of an illness or injury a group health insurance member cannot perform all the duties of his or her occupation but can perform some.

Liability for damages even though fault or negligence cannot be proven. Medicare The federal program established to provide health care coverage for eligible senior citizens and. Under this type of insurance coverage the cost of care is only covered if the policyholder visits a provider in the network.

Individual health insurancehealth insurance plans purchased by individuals to cover themselves and their families. For each claim free year in a health insurance policy the insurance company adds 5 per cent to the sum assured as an added benefit. Coinsurance refers to payment of a certain percentage of the medical expenses by the policyholder after the deductible has been met.

Note that until your deductible is met you are typically required to pay 100 of these expenses. What the Terms Mean. An HMO is a health plan that provides care through a network of providers doctors hospitals pharmacists to deliver medical care.

Exact definitions differ between health insurance plans. This glossary explains what the words and phrases mean for health insurance. A health insurance policy extends coverage against medical expenses incurred owing to accidents illness or injury.

What is the Definition of Health Insurance. The providers on the network agree with the HMO to lower rates for plan members. By estimating the overall risk of health care and health system expenses among a targeted group an insurer can develop a routine finance structure such as a monthly premium or payroll tax to ensure that money is available to pay for the health care benefits specified in the insurance agreement.

Coinsurance is the percentage of covered services that youre required to pay after your deductible is met. The process by which a premium or rate for a group is determined.

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