Main menu


12 health insurance terms you should know

It is essential to have health coverage for our times, as it provides a vital cushion for our money in unforeseen circumstances. The first step in choosing the best health insurance policy is to read and understand the features of the policy. Often times, we come across insurance terms that can be difficult to understand. You agree that having the correct knowledge and understanding of the insurance terms is essential to making the best decisions.

Therefore, below we list and explain frequently used health insurance terms.

1. Dependents

There are health insurance plans that provide coverage for an individual and their family members, such as a spouse and / or unmarried children and financially dependent parents. These individuals who are eligible for coverage are referred to as dependents in the policy.

2. Exceptions

Refers to medical situations or scenarios in which the insured is not eligible for health policy coverage.

3. Outlook free period

Indicates a specific period of time, from the date of receipt of the policy document, during which the insured can review the health policy and is allowed to cancel and return the policy. The insurance premium will be refunded after some discounts.

4. Grace period

It is the 30-day period immediately following the expiration date of the document period. The insured must pay the renewal premium before the end of this period to enjoy the coverage without losing interest.

5. Compensation

Compensation-based health insurance plans are those in which insurance companies provide coverage for the actual expenses incurred by the insured, in accordance with the terms and conditions of the policy. They differ from fixed benefit plans in that the insured pays a fixed amount as a lump sum when the insured person files a claim.

6. The insured person

An insured refers to an individual or group of individuals covered by a health insurance plan.

7. The believer

An insurer refers to an insurance company that provides insurance coverage for specific medical expenses incurred by the policyholder.

8. Network provider

In health insurance, a network provider refers to a hospital or any health care provider that has been authorized by the insurance company to provide a medical facility or non-cash health care / services at a reduced rate.

9. The period / duration of the document.

It is the period of time from the start of the health insurance policy to the expiration date, during which the insured is eligible for coverage.

10. A pre-existing disease

A pre-existing illness is a related illness, disease, injury, or condition for which a physician received / or diagnosed medical advice within the 48 months prior to the date the policy issued by the insurance company became effective or was reinstated to its previous condition.

11. Waiting period

It is the period during which the insured have to wait before being able to claim the medical expenses incurred with the exception of cases such as accidents. There is generally a 48-month waiting period for pre-existing conditions and 24 months for specific conditions / treatments.

12. Subscription

In health insurance, underwriting is the process by which the health insurance company evaluates the risks of a proposed health insurance and decides the health insurance premium that an individual must pay.