Accident only an insurance contract that provides coverage, singly or in combination, for death, dismemberment, disability, or hospital and medical care caused. A number of references were used in developing the definitions below. Definition of insurance contract european commission. Clients want to understand health insurance terminology and learn how it will affect not only the cost of their health insurance policy, but also their out or pocket expenses. Department of health and human services hhs dependent coverage. This system is an online health, automobile and travel insurance comparison portal. Health insurance portability and accountability act of 1996 hipaa health maintenance organization hmo health reimbursement arrangement hra health savings account hsa highdeductible health plan hdhp indemnity health plan. To be certified, a plan must provide essential health benefits and meet other health care reform rules. If you need to make a health insurance claim, visit gibl and download claim form of national insurance company. Glossary of commercial insurance terms commercial insurance is divided into two main categories. Blacks law dictionary 2nd ed is free to use online for your legal dictionary needs. Coinsurance is a percentage of the plans allowance for the service you pay 20% for example. A you can purchase health insurance online through our website.
An event or occurrence which is unforeseen and unintended. Consumer glossary national association of insurance. Members of ppos are free to receive care from both innetwork or outofnetwork nonpreferred providers, but will receive the highest level of benefits when they use providers inside the network. Accessible a term used to denote building facilities that are barrier free thus enabling all members of society safe access, including persons with physical disabilities. Many health insurance plans pay for part of the cost of prescription drugs, helping you to manage your medical spending. Health insurance terms explained when speaking with prospective clients, oftentimes there is confusion as to the meaning of certain insurance terms. Health insurance offers some protection against the detrimental effects of user fees and a promising avenue towards universal healthcare coverage.
Iec, developed the general insurance code of practice the code. Compare plans side by side, get health insurance quotes, apply online and find affordable health insurance today. Insurance company that actually underwrites and issues the insurance policy. Insurance definitions, dictionary, glossary and terms. Maryland health insurance program mhip medically necessary. Health insurance glossary of terms admitting privileges. Property insurance provides coverage for property that is stolen, damaged, or destroyed by a covered peril. When you assign benefits, you sign a document allowing your. Glossary of medical insurance terminology page 1 annual deductible is the amount you must pay each year for medical and mental health expenses before your medical plan begins to pay benefits.
Why is it important to know about health insurance. Health insurance terms explained insurance brokers in. Health insurance policy is being purchased by families and individuals who can afford to pay the medical bills. Download fulltext pdf national health insurance policy in nepal. The ability of a doctor to admit a patient to a particular hospital. These terms and definitions are available in additional languages via this page. Challenges for implementation article pdf available in global health action 20158. Moreover, we need to force the healthy to get health insurance or let insurer charge di erently for the sick from the healthy.
Health insurance protects you from the high cost of medical care by providing coverage for specific health care services. Some of these terms also might not have exactly the same meaning when. This document contains a list of commonly used health insurance terms and their definitions to help consumers better understand how health insurance coverage works. After paying 80 percent of losses up to a specified ceiling, the insurer starts paying 100 percent of losses. Insurance pdf types of insurance, scope of insurance. Glossary of commonly used healthcare acronyms and terms. Health insurance glossary page access your availability to medical care which is determined by where you live and the type of health care facilities available in your area. Which agency regulate insurance sector in india insurance service pdf. Glossary of health insurance terms blue cross and blue. A group of health care professionals who have contracted with your health insurance company to provide health care services. A group of health care providers who give coordinated care, chronic disease management, and thereby improve the quality of patient care. Broad categories include life, health, motor, travel, home, rural, commercial and business insurance. Accident for the purposes of health insurance, an accident is an unforeseen, unexpected and unintended event resulting in a bodily injury. A health insurance policy you buy directly from a health insurance company or broker rather than through an employer.
Durable medical equipment dme early and periodic screening, diagnostic, and treatment services epsdt eligibility assessment. Group model hmo an hmo that contracts with a single multispecialty. Glossary of health insurance terms blue cross and blue shield of. Thank you for choosing to learn more about residential title insurance. The term health insurance is a type of insurance that covers your medical expenses. Several types of employer group health coverage are available. Blacks law dictionary is americas most trusted law dictionary online. For a 20 percent health insurance coinsurance clause, the policyholder pays for the deductible plus 20 percent of his covered losses. Patient accounts, reimbursement, insurance this person deals with the patient billing and the handling of insurance forms. Those can be found in your insurance policy or certificate. Modified adjusted gross income magi nonpreferred provider. The amount you pay as your share for services you receive, such as a doctors visit. Health insurance glossary a accidentaccidental is to be defined as a sudden and unforeseen, involuntary act caused by external and.
Glossary of health insurance and medical terms page 1 of 4 glossary of health insurance and medical terms this glossary has many commonly used terms, but it isnt a full list. A benefit your employer, union or other group sponsor provides to you to pay for your health care services. These may range from a free standing center to a special area within a hospital and are known for having a more. Health insurance glossary health insurance definitions and.
The term refers to the fact that the company carries or assumes certain risks for the policyholder. Health care crisis overview this lesson plan is designed to be used with the film, critical condition, which tells the stories of four uninsured americans as they battle illness over a. The title sometimes given to this person is the director of patient accounts because they are in charge of the collectionpayment of the patients bills. Download health claim form national insurance company. An insurance company that accepts the risk transferred from. An explicit right of ownership and possession which is free from any restrictions or limitations, given to the insured.
A health insurance policy is a contract between an insurer and an individual group in which the insurer agrees to provide specified health insurance cover at a particular premium. Agent the insurance company representative who sells policies on behalf of the insurer. Glossary of health coverage and medical terms this glossary defines many commonly used terms, butisnt a full list. Health maintenance organization hmo a health care system that assumes both the financial risks associated with providing comprehensive medical services insurance and service risk and the responsibility for health care delivery in a particular geographic area to hmo members, usually in return for a fixed, prepaid fee. Glossary of health coverage and medical terms page 1 of 4 this glossary has many commonly used terms, but isnt a full list. Glossary of health insurance terms december 12, 2008 broker a salesperson who has obtained a state license to sell and service con tracts of multiple health plans or insurers, and who is considered to be an agent of.
Rita prasadildes manager queensland transcultural mental health centre september 2006 glossary of mental health. A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically. Health insurance article section is set to cater the best possible knowledge related to different health insurance products like family floater, senior citizen, critical illness and more. Insurance policies, a contract between the policyholder and the insurance company, are of different types depending on the risk they mitigate. The term property insurance includes many lines of available insurance. An individual plan can cover you andor any of your eligible family members. 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. This section is your complete guide to health insurance with limelight shed on the latest upcoming plans. Introduction to public health 4 mental health is the ability to learn and think clearly and coherently. Home health care glossary common definitions used in the home health care industry. Glossary of health insurance and medical terms this glossary has many commonly used terms, but it isnt a full list. Lecture notes on health insurance 2 of 2 if we want everyone to get health care, then the botton line is that we need to subsidize the sick at least somewhat. A flat dollar amount you must pay for a covered program.
Glossary of healthcare terms health insurance and reform. The health insurance marketplace, or health insurance exchange, is a federal government website where you can shop, compare and buy plans offered by participating health insurance companies in your area. Coinsurance a form of medical cost sharing in a health insurance plan that requires an insured. A flood, earthquake or other non preventable accident resulting from natural causes that occur without any human intervention. Download health insurance claim form of national insurance company from gibl. Request by an insured for the insurance company to cover an incurred loss. Understanding health insurance blue cross blue shield. Products and basic actuarial models 20263 health insurance products contd health insurance belongs to the area of insurances of the person, which includes life insurance in a strict sense. Health insurance plan buy online medical insurance plans.
The most comprehensive investing glossary on the web. Our website features products from many insurance companies and we help customers to compare various insurance plans and narrow down on the insurance policy that best suits customers needs and then facilitate online purchase of insurance policy in life insurance and. Health insurance can help you pay for expensive services like xrays, tests and surgery. Insurance terms used in the area of residential title insurance. Nov 04, 2006 your health insurance glossary nov 4, 2006 with words like copay, premium, and deductible, wading through the sea of health insurance terms can be overwhelming. For health insurance, it is a percentage of each claim above the deductible paid by the policyholder. This page provides a glossary of insurance terms and definitions that are commonly used in the insurance business. 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. If youre looking for a free download links of fundamentals of insurance pdf, epub, docx and torrent then this site is not for you.
I commend the efforts and contributions of all those involved in this project, particularly the project reference group. 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. Bold text indicates a term defined in this glossary. These glossary terms and definitionsare intended to be educational and may be different from the terms and definitions in your plan. Free torrent download fundamentals of insurance pdf ebook. There are both private and public health insurance plans, with different plans offering different benefits. Health insurance glossary health insurance definitions. You may have to pay a deductible each plan year before your insurance company starts to pay for your care. Although you generally pay a monthly premium and either copayments or co insurance, the cost for insurance is far less than medical care would be if paid fully outofpocket. In health insurance, the term copayment is also used to defin e a fixed monetary deduct ible applying to each occurence in addition to the annual deductible. Pursuant to article 921 of the civil obligations act under the insurance contract, an insurer undertakes to a policyholder to pay the indemnity to the insured person. Blacks law dictionary free online legal dictionary. Preferred provider organization ppoa health insurance plan that offers greater freedom of choice than hmo health maintenance organization plans. A way to figure out who pays first when two or more health insurance plans are responsible for paying the same medical claim.
Glossary december 12, 2008 health insurance terms this glossary defines terms that are commonly used to describe aspects of private health insurance. Title insurance provides coverage for losses that occur when a land title is not free and clear of defects e. An independent agent represents more than one company. When making decisions about health coverage, consumers should know the specific meanings of terms used to discuss health insurance. Fundamentals of insurance pdf kindle free download. The insurance contracts act allows an insurer to avoid a policy. Our home health care glossary will help you understand some of the more common terms, services and procedures used by professionals in the home health care industry.
Individual insurance policies are purchased from an insurance company by a person who pays the premium directly to the insurance company. Understanding your explanation of benefits pdf document. Insurance terminology north american training group, inc. The code is a selfregulatory form of regulation, that is, the insurance industry, not the government, is. But if you dont have insurance, you may have to pay for everything on your own. A comprehensive consumer guide to individual health insurance and coverage options, featuring expert analysis plus plan shopping and enrollment tools. Financial risk may be shared with the providers participating in the hmo.
If you like our services, kindly suggest our site to all your aspirant friends. Dictionary of insurance terms a absolute liability. Compensationer general an employee or former employee who is entitled to compensation and whom the department of labor determines is unable to return to duty. Additional terms are available through the glossary page. That is why choosing a health insurance plan that is right for you, and understanding how it works, may seem confusing. P q pq qualified health plan a health plan that is certified by the federal or state exchanges. Idf health insurance toolkit 33 coordination of benefits cob. Glossary of healthcare terms health insurance and reform accountable care organization aco. Below are definitions for some of the more commonly used terms and how.
Ahps would compete on the basis of offering highquality, lowcost care and would offer insurance and health care. On march 23, 2010, president obama signed the patient protection and affordable care act ppaca into law. Provides benefits in the event of an accident occurring during the. Different health insurance policies can offer different benefits, and some can limit which doctors, hospitals, or other providers you can use. The definitions in this glossary are developed by the naic research and actuarial department staff based on various insurance references. The items on a balance sheet showing the value of property owned. In fact, when you buy health insurance online, you get additional benefits like generation of health insurance policy documents instantly, etc. Any activity done to help a person or group get something the person or group wants or needs. Liability for damages even though fault or negligence cannot be proven. The insurance council of australia, as a response to the needs of the insurance industry and with the assistance of the insurance enquiries and complaints ltd. It serves as an introduction to health insurance from the point of view of consumers under the age of 65 who purchase a health insurance plan.
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