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16 terms

Health Insurance Policy General Terms

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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