Financial Lit-Ch 27
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Created by:
thompsoncnevada Plus on April 2, 2012
Subjects:
Description:
Managing Your Personal Finances
Ryan
Chapter 27
Health and Life Insurance
Classes:
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61 terms
Terms | Definitions |
|---|---|
 health insurance | a plan for sharing the risk of high medical costs related to injury or illness |
| group insurance | the most common type of this kind of insurance; all those insured have the same coverage and pay a set premium; often obtained through employers |
| COBRA | a law that allows people who leave employment to continue their health insurance under the company plan for 18 months |
| HIPAA | limits the pre-existing conditions that group plans may exclude; it makes it illegal for an insurer to deny coverage based on health status, though it does not limit the amount the insurer may charge |
| pre-existing conditions | medical conditions or symptoms that were known to the participant or diagnosed within a certain time period before the effective date of the plan |
| double coverage | a group health insurance provision that specifics how the insurers will share the cost when more than one policy covers a claim |
| Flex 125 Plan | employee benefit program that allows employees to set aside money, pretax, to help pay deductibles, co-payments, and other health expenses not covered by insurance; however if you don't use it, you lose it |
| supplemental insurance | a secondary insurance policy used to help pay high deductibles and co-payments |
| individual insurance policies | health insurance coverage not as part of a group; requires an exam; is usually expensive |
| basic health insurance | medical, hospital, surgical costs |
| medical coverage | covers physician care that does not include surgery such as office visits, x-rays, and lab tests |
| hospital coverage | covers hospital bills for room, board, and medication |
| surgical coverage | covers surgeon's fees |
| major medical coverage | protection against catastrophic expenses of a serious injury or illness; usually has a lifetime maximum |
| stop-loss provision | insurance clause that caps a maximum that the insured has to pay during any calendar year |
| dental insurance | covers dental exams, cleaning, and dental x-rays, and fillings |
| vision insurance | covers eye exams |
| unmanaged care | a plan that allows participants to chose any doctor and to be reimbursed for a portion of the expenses incurred after a deductible is met |
| managed care | health care plan that relies on a network of health care providers; participants must select doctors who belong to the network; must have pre-approval for surgery |
| types of managed care plans | HMO PPO POS |
| HMO Health Maintenance Organization | group plan offering medical care to its members; patients must choose doctors on the staff including their primary care physician |
| primary care physician | main health care provider |
| examples of preventative care | routine physical exams and vaccinations |
| preventative care | treatment before a minor ailment becomes a major problem |
| capitated | per person |
| PPO Preferred Provider Organization | a group of health care providers who band together to provide health services for set fees; patients can choose doctors from an approved list but can go outside the plan but have to pay a higher fee |
| POS Point of Service | combination of HMO's and PPO's |
| Medicare | government-sponsored health insurance for people aged 65 or older; run by social security administration |
| medicap insurance | a supplemental private insurance policy to pay deductibles and co-payments |
| Medicaid | government-sponsored health insurance for people with low incomes |
| high-risk pools | make it possible for people who are otherwise "un-insurable" to obtain some type of coverage |
| disability insurance | an insurance plan that makes regular payments to replace inocme lost when illness or injury prevents the insured from working |
| income protection | another name for disability insurance |
| waiting period | the amount of time one must wait for insurance benefits to begin |
| duration of benefits | the length of time an insurance company will pay disability insurance |
| guaranteed renewability | protection against cancellation of an insurance policy |
| OASDI Old age, survivors, and disability insurance | government-sponsored disability insurance |
| worker's compensation | a form of insurance paid by the employer providing cash benefits to workers injured or disabled in the course of employment. |
| life insurance | provides funds to the beneficiaries when the insured dies |
| mortality tables | statistical tables used to gather life expectancy |
| group life insurance | insurance plan that insures a large number of people under the terms of a single policy without a medial examination |
| portability | when you leave your employer, you are able to continue paying the premiums and convert your group into an individual policy |
| beneficiaries | people named in an insurance policy who will receive the benefits of the policy |
| incontestable clause | provision of a life insurance policy stating that once the policy has been in effect for a stated period of time, the insurer many no longer question items on the application or deny coverage |
| life insurance rider | small insurance policy that modifies the coverage of the main policy |
| waiver of premium | allows one to stop making payments and keep coverage in force if you become disabled |
| guaranteed insurability | riders that five you the right to renew a policy or buy additional coverage regardless of changes of health |
| double indemnity | the beneficiary is paid double the face value of the insurance policy |
| temporary life insurance | a life insurance policy that lasts for a specific period |
| permanent life insurance | a life insurance policy that lasts for life |
| term life insurance | life insurance policy that remains in effect for a specific period of time |
| pure life insurance | another name for term life insurance |
| decreasing term insurance | the amount of coverage decreases each year while the premium remains the same |
| level term insurance | the amount of coverage remains constant from beginning to the end |
| credit life | this insurance can be used only to repay a specific debt should the borrower die before doing so; obtained through a lender |
| renewable term life insurance | the policy holder has the right to renew each year without passing a physical exam |
| cash value | the savings accumulated in a permanent life insurance policy that the policy holder receives if their policy is cancelled |
| whole life | a life insurance policy that you pay fixed premiums throughout your life and the policy pays a stated sum at death |
| limited-pay life | a life insurance policy that premiums are limited to a specific number of years or until age 65; at that time, you no longer have to pay any more premiums and the insurance company will pay face value of the policy at the time of death |
| universal life | life insurance which combines the low cost protections of term insurance with a savings component that is invested in a tax deferred account |
| variable life | life insurance premiums are invested in market securities |
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