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| Uncertain, unpredictable factors that can lead to losses or damages |
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| An arrangement in which an insured pays money to an insurer to gain protection against risks and compensation for losses |
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| A written contract stating the arrangement between insured and insurer |
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| A consumer who has purchased an insurance policy |
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| potential risks and losses against which an insured is protected by a policy |
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| a fee paid to an insurance company on a regular basis for coverage |
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| an initial amount paid by insured for a loss before insurance compensations begin |
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| Provides compensation for losses due to injury, illness, or disability |
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| Pay a large part of hospital and medical care, may also pay part of some other expenses (e.g. doctor’s visits) |
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| Pays for long-term illness expenses after basic medical benefits limits have been reached (e.g. cancer). |
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| Health management organizaiton---a health care group that provides health care services to members for a set fee and a small co-pay. |
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| Health savings account---you contribute pre-tax dollars to the account for expected medical expenses for the coming year-often set up through your employer-submit claims and receipts for reimbursement up to amount deposited. |
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| Preferred providers organization---an agreement between health providers with empoloyers or insurers to provide services at a reduced rate to employees. |
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| Point of service---members use a primary physician who refers them as needed to participating specialists or members can see non-participating specialist members. But, members pay more to use non-participating health providers. |
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| A plan in which an insured can select his/her own doctors and hospitals, pay costs at time of visit, and file form with insurance company for reimbursement of covered expenses |
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| Childrens Health Insurance Program - health insurance for children under 18 whose parents earn too much to qualify for Medicaid, but not enough to afford private insurance. Federal funds are distributed by |
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Definition
| an illness or injury that leaves a person unable to work |
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| pays for care when a person with a serious illness or injury cannot care for themselves for an extended period of time |
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| employers are required to have in every state in some form |
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| may be purchased by medicare recipients to cover part/all expenses covered by medicare |
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| a federal law that someone who leaves employment may eligible to keep insurance coverage at his/her own expense up to 6months |
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Definition
| An illness or injury that a person has at the time he/she enrolls in a health care plan |
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| A patient’s right to restart coverage annually |
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| A limit on the number of days one’s care will be covered, or the highest amount that can be paid in benefits for a specific procedure |
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| A time period during which a person can enroll in a health care plan |
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| A medical service that is not covered |
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| Requirement to obtain approval from the plan before having certain treatments or procedures done |
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| A doctor who provides general medical care and coordinates other health care. |
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| A group or individual selected to receive the assets of a person when he/she dies |
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Term
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Definition
| Assets or gain received by having an insurance policy |
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Definition
| The amount of money payable to a beneficiary as a death benefit when an insured dies |
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Definition
| The length of time it takes an insurance policy to reach it full value |
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Definition
| The amount of money a whole life policyholder would receive if the policy were surrendered before death or maturity. |
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