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Important terms and definitions in Health Insurance

Important terms and definitions in Health InsuranceIf you are one of the many millions of Americans who opt for fast food rather than health meals and lead an unhealthy lifestyle, then it is crucial that you recognize the significant role of health insurance in your life. It actually keeps you away from the unforeseen medical expenses and impending financial risk.

If you are really going to connect yourself with health insurance at any point of time in life, then you should be acquainted with following terms and definitions to understand the topic properly;
  1. Accumulation Period – Time frame for which deductible amounts are calculated within the tenure of a policy.
  2. Coinsurance – It is a form of sharing medical costs, usually pre-decided in percentage, which needs to be paid after the deductible amount, if any, has been paid. For example, the insurance company pays 80% of the medical expenses, while the person pays remaining 20%.
  3. Copayment – It is similar to coinsurance. Here, a predetermined fixed fee is paid by an individual for health services, apart from what is covered under insurance.
  4. Covered Expenses – The medical expenses that will be reimbursed to the insured or paid directly to the provider of the service, as per the terms of insurance policy.
  5. Deductible – Amount that a person pays for medical expenses in the benefit period before the insurance company makes payments for covered medical services.
  6. Denial of Claim – It is the refusal made by the insurance company to honor the request made by an individual to pay for the healthcare services received.
  7. Dependent – A person who is completely relied on the policyholder. This includes spouse and/or unmarried children of the policyholder. They are entitled to receive the support in the form of monetary benefits from insurance company.
  8. Effective Date – Date from which the insurance coverage begins i.e. date of commencement of insurance coverage.
  9. Exclusion – These are provisions under the insurance policy that eliminates coverage for certain action, type of damage, property or location.
  10. Explanation of Benefits – It is the written explanation given by an insurance company regarding a claim made. It states what the company has paid and for what the payment needs to be made by the client.
  11. Length of Stay – It is the term used for the amount of time an individual is in the hospital or some in-patient facility.
  12. Premium – It is the fees agreed upon that needs to be paid for coverage under the insurance policy to get benefits in a definite period of time.
  13. Risk – It is the chance or the degree of probability or the amount of possible loss to an insuring company.

If you are going to have health insurance in near time, then it is very essential for you to wisely interpret different terminologies associated with health insurance. Above terms and definitions will definitely help you in differentiating the subtle meaning involved in your insurance policy. This will really help you in understanding insurance policy in more transparent and efficient way.