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LifeInsuranceTerms

Student Produced Definitions

QuestionAnswer
Affordable Care Act Landmark health reform legislation passes by the 111th Congress and signed into law by President Obama
Beneficiary Enrolled in a health insurance plan and receives benefits through those policies.
Benefit Amount pay paid to you by insurance company when insured suffers a loss.
Brand-name drug Prescription drugs marketed with a trademarked name.
Carrier Insurance company offering a health care plan.
Claim A request a person makes to an insurance company to pay for services obtained from a health care professional.
COBRA Legislation that allows you to continue your healthcare plan through a former employer for up to 18 months after you leave that job. You pay for all costs.
Coinsurance Both you and the insurance company pay part of the cost of medical services you receive.
Copayment A predetermined amount you pay every time you visit a health care provider.
Deductible The amount a person pays for health care before the insurance company covers the rest.
Dependent A person who relies on a policy holder for health insurance coverage.
Effective date The date your insurance coverage kicks in.
Employer-sponsored health insurance Your place of employment buys all or part of your health insurance.
Employer-sponsored health plans Your employers covers your health care costs out of a pool of money it sets aside to pay for health care costs. It doesn't buy policies.
Exclusion A provision on a health care insurance policy that gets rid of coverage for certain acts, property, types of damage or locations.
Generic drug Once a prescription drug's brand name expires, other companies can sell it using the chemical name.
Group health insurance All people in the group pay in. Healthy people that do not use the insurance helps to pay the costs of people who do use healthcare services.
Guaranteed issue Health insurance that covers people no matter the health issue. As long as the premium is paid, coverage continues.
HMO Equal monthly fees no matter how many times you visit.
In-network You can take advantage of a discounted cost by using healthcare providers that have signed an agreement with your health insurance company.
Limitations A maximum amount paid by the insurance company for a specif service.
Long-term disability insurance Pays you a part of your monthly earnings if you can no longer work due to a medical condition.
Managed care A health care system that attempts to control both the quality and cost of medical services.
Medicaid Health Insurance for the poor.
Medical Underwriting A process used to evaluate whether or not to accept an applicant for health coverage for a certain premium rate.
Medicare Health insurance for senior citizens and disabled people.
Network A group of healthcare provide that provide services at a lower price.
Out-of-pocket maximum The most you'll have to pay per year.
Outpatient A person who gets medical services without spending a night in the hospital.
Pre-existing condition A health issue you had prior to buying a health insurance policy.
Primary care provider Your doctor. They refer you to specialists.
Private health insurance When you buy your own health insurance directly from an insurance company.
Provider Healthcare professionals who help you out with health issues.
Rescission An insurance company issues you a policy, then revokes it because you did not tell the truth on the insurance application.
Rider A modification to a health insurance policy.
Second opinion Medical opinion by a different doctor as to whether or not you need a certain procedure.
Short-term disability Getting paid when your not working to to an injury or condition that is quickly resolved.
Single-payer system One insurance company for everyone.
Socialized medicine The Government controls the health insurance industry.
Student health insurance School sponsored health care plans.
Underwriter The insurance company accepts you and agrees to pay your health care costs as outlined in the insurance policy.
Waiting period A period of time where you cannot use your insurance.
Created by: dlemay