| A | B |
|---|
| risk | Uncertain, unpredictable factors that can lead to losses or damages |
| insurance | An arrangement in which an insured pays money to an insurer to gain protection against risks and compensation for losses |
| policy | A written contract stating the arrangement between insured and insurer |
| policyholder | A consumer who has purchased an insurance policy |
| coverage | Potential risks and losses against which an insured is protected by a policy |
| premium | A fee paid to an insurance company on a regular basis for coverage |
| deductible | An initial amount paid by insured for a loss before insurance compensations begin |
| health insurance | Provides compensation for losses due to injury, illness, or disability |
| basic medical | Pay a large part of hospital and medical care, may also pay part of some other expenses (e.g. doctor’s visits) |
| major medical | Pays for long-term illness expenses after basic medical benefits limits have been reached (e.g. cancer). |
| HMO | Health management organizaiton---a health care group that provides health care services to members for a set fee and a small co-pay. |
| HSA | 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. |
| PPO | Preferred providers organization---an agreement between health providers with empoloyers or insurers to provide services at a reduced rate to employees. |
| POS | 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. |
| fee-for-services plan | 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 |
| CHIP | 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 |
| disability | An illness or injury that leaves a person unable to work |
| long term care | Pays for care when a person with a serious illness or injury cannot care for themselves for an extended period of time |
| worker’s compensation | Employers are required to have in every state in some form. Covers medical care, treatment, rehabilitation, and a portion of wages from injuries that occur in the workplace. |
| Medigap insurance | May be purchased by Medicare recipients to cover part/all expenses not covered by Medicare. |
| COBRA | A federal law that someone who leaves employment may be eligible to keep insurance coverage at his/her own expense up to six months. |
| pre-existing condition | An illness or injury that a person has at the time he/she enrolls in a health care plan |
| renewability | A patient’s right to restart coverage annually |
| maximum benefit | 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 |
| open enrollment period | A time period during which a person can enroll in a health care plan |
| exclusion | A medical service that is not covered |
| preauthorization | Requirement to obtain approval from the plan before having certain treatments or procedures done |
| primary care physician | A doctor who provides general medical care and coordinates other health care. |
| beneficiary | A group or individual selected to receive the assets of a person when he/she dies |
| insurance benefits | Assets or gain received by having an insurance policy |
| face value | The amount of money payable to a beneficiary as a death benefit when an insured dies |
| maturity | The length of time it takes an insurance policy to reach it full value |
| Cash value | The amount of money a whole life policyholder would receive if the policy were surrendered before death or maturity. |
| term insurance | A type of insurance that provides coverage for a specific period of time with no investment benefits |
| level term | premiums and death benefits stay the same for the life of the policy |
| decreasing term | premiums stay the same but the benefits decrease over the life of the policy e.g. for home mortgage |
| renewable term | the insured person can renew the policy without taking a physical |
| convertible term | the insured person can change the policy from convertible to permanent without taking a physical, tends to be more expensive |
| permanent life | (also called cash value life insurance) provides coverage the person’s entire life and includes an investment component |
| whole life insurance | a type of insurance that provides coverage for a whole lifetime and grows in face value as premiums and cash accumulate. |
| limited payment life | coverage for entire life but premiums are higher than whole life because premiums are paid for a set number of years or until a set age |
| universal life | allows adjustments of premium, face value, and level of protection |
| variable life | premiums are fixed, but face amount varies with investment results |
