| A | B |
|---|
| Accidental Bodily Injury | Injury to the body of the insured, as the result of an “accident”. |
| Accident | A sudden and unforeseen event, resulting in a loss. |
| Accidental Means | Takes into account both the cause and the effect of the event, rather than just the injurious result of the event. |
| Sickness Insurance | Covers losses resulting from illness or disease, it does not cover accidental injury |
| Hospital and Medical Expense policies | Reimburse the insured, totally or partially, for the medical costs in treating a disability or an illness. |
| Long-Term Care Expense policies | Cover the type of care that an individual may require if he or she is unable to attend to their daily needs due to prolonged sickness, disability, or degenerative diseases or illnesses. |
| Individual Accident & Health policies | Personally owned by the insured and purchased through a private insurance carrier. |
| Group Accident & Health policies | Provide coverage to members of a group |
| Private Accident & Health policies | Offered through an individual’s employer, or purchased by the individual and premiums are paid entirely or in part by the individual insured |
| Government (Public) Accident & Health policies | Subsidized or paid for entirely by government (public) funds. |
| Limited Benefit (Supplemental) Accident & Health policies | Cover expenses that are not included in a medical expense policy (dental care, disability income, and specified dread disease. |
| Comprehensive Major Medical Accident & Health policies | Include all of the basic medical expense coverages into a single policy, ranging from hospital and surgical coverage, to dental and miscellaneous medical expenses. |
| Fully-Insured Accident & Health policies | Cover groups of an employees while their employer pays the premium to the insurance company. The employer’s premiums will stay fixed for a year, unless the number of employee’s covered under the plan changes. |
| Self-Insured (Self-Funded) Accident & Health plans | Operated by the employer and allows them to save the profit-margin that an insurance company adds to the premium it charges. |
| Accident-Only policies | Cover insureds for death, dismemberment, disability, or hospital and medical care that was caused by an accident. |
| Hospital Indemnity Insurance | Provides weekly or monthly income benefits to an insured to pay the expenses of daily living while the insured is hospitalized |
| Dental Insurance policies | Usually provide what is known as “100-80-50” coverage. This means the policy usually covers 100% of the preventive care, 80% of fillings and root canals, and 50% for crowns, bridges, and major dental care. |
| Specified (Dread) Disease policies | Provide benefits for a single disease, or group of diseases, to supplement major medical coverage in the case that high costs are incurred in treating a serious illness such as cancer. |
| Vision Coverage (Eye Care Policies) | Provides supplemental coverage for eye examinations, contact lenses, eyeglasses, and/or eye glass frames. |
| Common Exclusions | Workers Compensation, Cosmetic Procedures, Experimental Treatment, and Medically Necessary Treatments |
| CMS-1500 | Universal claim form for Health insurance policies and maintained by the National Uniform Claim Committee (NUCC). |
| CPT | Current Procedural Terminology |
| ICD | Classification of Diseases indicating a diagnosis |
