Words associated with surety and bonds and title insurance are listed separately at the end of this list. Health insurance glossary health insurance definitions. Health insurance is full of terms you may not know. Getting to know and understand the terms can go a long way to help you understand the plan and thus choosing the best one.
Health insurance is one of the most important purchases you make, yet many of us feel helpless when it comes to shopping for coverage. Our comprehensive, easytouse glossary provides definitions for common health insurance terms to help you better understand your health care. These definitions provide a brief description of the coverages progressive offers and some of the terms and phrases used in connection with homeowners insurance. Over the past 30 years, the financial and legal structure of such insurance has varied. This document contains a list of commonly used health insurance terms and their definitions to help consumers better understand how health insurance coverage works. Health insurance terms university of south florida. Glossary of health insurance terms blue cross and blue. Here you will find some key insurance terms and definitions. After the out of pocket maximum has been met, the insurance company and policy will pick up 100% of all medical costs. When making decisions about health coverage, consumers should know the specific meanings of terms used to discuss health insurance. Speaking the language also helps avoid misunderstandings and minimize extra steps or backandforth with your insurance company. Glossary of insurance terms the az for insurance practitioners terms generally associated with reinsurance ab initio a term used to describe avoidance of a contract from its inception or its beginning.
These health insurance terminologies will give you a better understanding of health. This document is for informational purposes only and is not intended to alter or replace the insurance policy. This glossary explains what the words and phrases mean for health insurance. These terms and definitions are available in additional languages via this page.
It is called 340b since that is the section of the public health. Start studying health insurance terminology quiz 1. Explanation of benefitsthe health insurance companys written explanation of how a medical claim was paid. Our insurance terms glossary is divided alphabetically by insurance terms in a quick reference guide to assist understanding the language commonly used by insurance companies. A form of medical cost sharing in a health insurance plan that requires an insured person to pay a stated percentage of medical expenses after the deductible amount. Coinsurance a form of medical cost sharing in a health insurance plan that requires an insured person to pay a stated percentage of medical expenses after the deductible amount was paid.
Exclusion or limitationany specific situation, condition, or treatment that a health insurance plan does not cover. As you experience changing events in life and take on greater responsibilities, you may need to manage different kinds of life, health, automobile or home insurance. Medical insurance glossary of terms health medicare pdfs. Just over 200 million americans have health insurance coverage from commercial or private market health insurance. Some of these words are common with many types of insurance. How to understand your costs and key health insurance terms. Insurance is an intricate product and so is its glossary. Definitions of health insurance terms in february 2002, the federal governments interdepartmental committee on employmentbased health insurance surveys approved the following set of definitions for use in federal surveys collecting employerbased health insurance data. These clauses are sometimes found in the contracts health insurers enter into with. Texas department of insurance glossary of common insurance terms.
Glossary of life insurance terms department of financial. Common insurance terms and definitions because some insurance language can be confusing, the following are common terms and definitions that church leaders should be familiar with when they are making purchasing decisions regarding obtaining an insurance policy for their church. Find understandable and helpful definitions for common health insurance and healthcare terms in medical mutuals health insurance glossary. While these terms can be confusing, the better you understand them, the better you will be prepared to successfully gain coverage and access to the treatments that are right for you. Jan 07, 2014 this document contains a list of commonly used health insurance terms and their definitions to help consumers better understand how health insurance coverage works. No insurance website could be complete without offering and index of insurance terms and definitions.
Life insurance resource center glossary of life insurance terms agent an insurance company representative licensed by the state who solicits and negotiates contracts of insurance, and provides service to the policyholder for the insurer. On march 23, 2010, president obama signed the patient protection and affordable care act ppaca into law. Its okwe know as well as anyone that the language of health insurance can be hard to understand. Glossary of insurance terms this list is not meant to be all inclusive, but should help with your understanding some insurance terms used in our website. The glossary may not be modified by plans or issuers. A health insurance plan that meets the minimum essential coverage requirements under the affordable care act. Facilities, providers, and suppliers that provide health care services at a set cost to people in a health insurance plan.
Insurance glossary understanding common insurance terms this glossary provides insurance terms definition and explanation commonly used in insurance business world. Here, youll find plainenglish definitions for 33 of the most common insurance terms. Please further note that definitions and plan options. For health insurance, it is a percentage of each claim above the deductible paid by the policyholder.
Learning about life insurance can be a daunting task, especially if one doesnt know the meaning of the specialized words, of which there are many. The 340b drug pricing program enables eligible health care organizations known as covered entities to purchase drugs from manufacturers at reduced prices. Glossary of medical insurance terminology pdf uc merced. Health insurance terminology quiz 1 flashcards quizlet. Health insurance and obamacare terms what does health reform mean to you. Simply having the basic understanding of insurance definitions can make the difference between having a plan that will cover you for the majority of your medical expenses and one that. An agent can be independent agent who represents at least two insurance companies or a direct writer who represents and sells policies for one company only. Webmd provides definitions of terms related to health insurance, the affordable care act and medicare. It contains detailed information about what the company paid and what portion of the costs you are responsible for. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Health insurance reimburses the costs of necessary medical treatment in the event.
Insurance plans can differ in which providers you can see and how much you have to pay. Glossary of insurance terms actuary a professional trained in the mathematics of insurance and risk management, including the calculations of premiums, policy reserves and other values. Health care services that your health insurance or plan doesnt pay for or cover. You have another option, which is commonly called traditional, indemnity or feeforservice insurance, as well. Yet every day, its becoming more and more important for health care consumers to have at least a basic knowledge of the industrys terminology.
Consumer glossary national association of insurance. Insurance definitions, dictionary, glossary and terms. Many of the terms you encounter when dealing with health insurance are not familiar. The federal poverty level fpl is the set minimum amount of. Glossary of health coverage and medical terms page 1 of 4 glossary of health coverage and medical terms this glossary has many commonly used terms, but isnt a full list. Health care abbreviations, acronyms and definitions a. Common health insurance terms and definitions wps health. In this life insurance glossary, we have defined many of these terms used throughout this website and, perhaps in your policy. Some of these terms also might not have exactly the same meaning when. The insurance contracts act allows an insurer to avoid a policy ab initio in situations where an insured fraudulently non disclosed or fraudulently misrepresented. We have had people ask for a place to quickly look up certain health insurance terms. Weve curated a list of advanced and basic insurance terms and their definitions to better help you understand the often confusing world of insurance. The definitions in this glossary are developed by the naic research and actuarial department staff based on various insurance references.
To view pdf files on this website you need the free adobe reader. Glossary of health coverage and medical terms just plain clear. Are you new to health insurance or just want a better understanding of how it works. Jun 25, 2015 a most favored nation mfn clause is a contractual agreement between a supplier and a customer that requires the supplier to sell to the customer on pricing terms at least as favorable as the pricing terms on which that supplier sells to other customers. Copayment a form of medical cost sharing in a health insurance plan that requires an insured person to pay a fixed dollar amount when a medical service is received. Pdf health insurance is one of the ways that people in various countries finance their medical needs. These plans are offered through blue cross and blue shield of illinois or a health insurance agent. A complaint that you communicate to your health insurer or plan. Accountable care organizations acos actuarial equivalence.
Members can take a free confidential hearing test by phone. In the united states, this level is determined by the department of health and human services. Items and services that are covered by your insurance 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. Its important to understand your costs and key health insurance terms, so youll know what services your plan will pay for and how much each visit or medicine will cost. An independent agent represents more than one company. The insurance products taken out for you are shown in your insurance policy which you receive from your insurance broker. Glossary of health insurance terms december 12, 2008. Name and describe the various kinds of business insurance. Insurance cover including the sums insured and rules on deductibles is definitively described in the terms and conditions of insurance. On march 23, 2010, president obama signed the patient protection and affordable care act ppaca into. Below are definitions for some of the more commonly used terms and how ppaca impacts their use. Annual deductible is the amount you must pay each year for medical and mental health expenses before your medical plan begins to pay benefits.
This section of our website can help you learn everything you need to know, from common terms and acronyms to how to budget for and select the right health plan for you and your family. Some of these terms might not have exactly the same meaning when used in a policy or plan, and in any such case, the policy or plan governs. Some of these terms also might not have exactly the same meaning. Allowed amount the highest amount we will cover pay for a service. Additional terms are available through the glossary page. Glossary of health insurance terms india policybazaar. Please further note that definitions and plan options may vary by state and plan. See if you qualify for a special enrollment period. With just a few clicks you can access the geico insurance agency partner your boat insurance policy is with to find your policy service options and contact information. Compare plans side by side, get health insurance quotes, apply online and find affordable health insurance today. In february 2002, the federal governments interdepartmental.
Examples of insurance related terms to be defined are. Need help with insurance terms and insurance definitions, see the insurance dictionary and glossary. These plans are not offered on the health insurance marketplace and are not eligible for the premium tax credit. Glossary of health care terms health insurance illinois. In february 2002, the federal governments interdepartmental committee on. Eye health insurance glossary definitions of common terms. The defined terms and coverage provisions in your policy or certificate of insurance, such as reasonable and customary, may be different from the general information provided below, and the policy or certificate language will prevail. Also see the health and life insurance glossary, small business insurance glossary and terminologies used in insurance and their meanings. Health plan employer data and information set hedis.
Glossary of health insurance terms national health policy forum. Health insurance glossary health insurance definitions and. Agent the insurance company representative who sells policies on behalf of the insurer. These definitions are not applicable in all states or for all products. Glossary of health insurance terms blue cross and blue shield of.
Glossary of insurance terms national insurance brokers association. If you should have any questions or would like to see a specific term added, please contact us. Following is the property and casualty insurance glossary of basic insurance terms and definitions that are commonly used in the insurance industry. Jul 31, 2014 15 health insurance terms explained simply. The health insurance deductible definition, quite simply, is the amount of money the insurance company requires the subscriber to pay before the health insurance starts to pay claims.
This page provides a glossary of insurance terms and definitions that are commonly used in the insurance business. The following glossary of terms will help you understand some of the commonly used terminologies that are related with health insurance in general and vision insurance in particular. Health insurance terms and definitions valuepenguin. To help you better understand health insurance, heres a list of the most commonly used health care terms and definitions. Published on july 31, 2014 july 31, 2014 48 likes 5 comments. Group code a unique three to five digit number assigned by the naic to identify those companies that are part of a larger group of insurance companies. Glossary of commonly used healthcare acronyms and terms. Sep 17, 2019 out of pocket maximums generally do not include the monthly premiums paid for insurance.
Below are definitions for some of the more commonly used terms and how. These glossary terms and definitions are intended to be educational and may be different from the terms and definitions in your plan. In february 2002, the federal governments interdepartmental committee on employmentbased health insurance surveys approved the following set of definitions for use in federal surveys collecting employerbased health insurance data. It is important to understand these definitions when choosing a policy or understanding coverage. This page provides an index of insurance terms and.
Knowing these terms can help you choose a plan that meets your needs. Instead of, or in addition to, paying a fixed amount up front a copayment or deductible, the co insurance is a percentage of the total cost that insured person may also pay. An hmo is a health plan that provides care through a network of providers doctors, hospitals, pharmacists to deliver medical care. Group health health insurance issued to employers, associations, trusts, or other groups covering employees or members andor their dependents, to whom a certificate of coverage may be provided. Health insurance covers the cost of hospitalization, visits to the doctors office, and prescription. These glossary terms and definitionsare intended to be educational and may be different from the terms and definitions in your plan. The three most common managed health insurance plan choices are. Insurance plan types hmo health management organization. Health care abbreviations, acronyms and definitions a aahp american association of health plans aapcc adjusted average per capita cost the estimated average cost of medicare benefits for an individual in a county, based on factors of age, sex, institutional status, medicaid, disability, and end stage renal disease status. Knowing these 9 individual health insurance terms will help you select the best personal plan for your family. Important insurance terms finding an affordable student health insurance plan can be difficult, especially if there are insurance terms you dont understand. Glossary of health insurance terms skip secondary navigation ribbons.
Insurance glossary understanding common insurance terms. An individual plan can cover you andor any of your eligible family members. Health care services that help a person keep, learn or. It is called 340b since that is the section of the public health service act that establishes the program. Additionally, this informational sheet is not intended to fully set out your rights and obligations or the rights and obligations of the insurance company. Glossary of health coverage and medical terms this glossary defines many commonly used terms, but isnt a full list. Medical insurance terms and abbreviations health medicare pdfs. Read through our health insurance glossary and learn what each term means and how it may impact your health insurance buying decisions. Oct 14, 2014 basic insurance terminology and definitions about life, health, automobile and home insurance to help you understand basic concepts and buy the right insurance.
The insurance contracts act allows an insurer to avoid. Coinsurance a form of medical cost sharing in a health insurance plan that requires an insured person to pay a. Remove confusion from your health insurance shopping. A deductible is a costsharing requirement under a health insurance policy that provides that the insurer will not be liable for a specified rupee amount in case of indemnity policies and for a specified number of dayshours in case of hospital cash policies which will apply before any benefits are payable by the insurer. These glossary terms and definitions are intended to be educational and may be different from the terms and definitions in your plan or health insurance policy. Understanding your explanation of benefits pdf document. Glossary of common health insurance terms cf foundation. Reduce the confusion around common health insurance terms and definitions. These glossary terms and definitionsare intended to be educational and may be different from the terms and definitions in your plan or health insurance policy. Here we have listed and defined a few common terms used in health insurance. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Some of these terms also definitions of health insurance terms.
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