Health Insurance Policy General Terms

16 terms by DesBella

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Premium

Fee paid to the insurance company to keep the health insurance policy active; paid monthly, quarterly, or annually by the unsured or group

Grace Period

Number of days allowed between the premium due date and cancellation of health insurance coverage; usually 10 to 30 days

Guaranteed renewable

Insurance company must renew the health insurance policy as long as the premiums are paid

Conditionally renewable

Insurance company may refuse to renew the health insurance policy at the end of a payment period.

Optionally renewable policy

Insurance company may or may not renew the health insurance policy on a specified date; may increase rates and decrease coverage

Cancelable Policy

Insurance company may cancel the health insurance policy at any time for any reason

Noncanceable policy

Insurance company must renew the health insurance policy; the policy may have age-related limitations

Benefit

Amount paid by the insurance company for covered medical expenses

Hospital benefit

Amount paid by the insurance company for hospital expenses; either a percentage of the charge or a specific dollar amount.

Surgical Benefit

Amount paid by the insurance company for expenses related to a surgical procedure.

Major medical benefit

A fixed amount of money available for the lifetime of the insured and any dependent.

Extended Care benefit

Amount paid by the insurance company for nursing facility or long-term care expenses

Exclusions

Situations that are not covered by a health insurance policy

Pre-existing conditions

Health conditions that were treated or existed before the individual was covered by the health insurance policy

Waiting Period

Period of time before specified illnesses or accidents are covered by the insurance policy

Waiver

An attachment to the insurance policy that excludes conditions that would otherwise be covered by the insurance policy

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