There are some important terms in health insurance, and they cover a variety of medical situations. These include accident benefits, disability income, emergency room visits, hospitalization, maternity, mental health, dental, life and death insurance, and rehabilitation or accident insurance. Early on we recommend that you visit Apply for Medicare’s website to be better guided.
Each of these is important to know if you find yourself covered by an employer-sponsored health insurance plan or are self-employed. Your coverage may change from state to state, as well as the kind of plan you have. So it’s very important to know what those terms mean!
Accident benefits refer to any payments made to you following an accident, whether it be a car crash a fall, or another injury. If you are injured in such a situation that you require medical care for your injuries, this part of your insurance plan may pay for it.
This term insurance is usually called permanent coverage because it lasts until your death or cancellation. Therefore, your insurance company will not cancel your plan until you’re no longer able to work. Permanent accident insurance is usually purchased by people who have suffered only one injury, or one major accident.
Disability income coverage is designed to supplement your regular income. This type of plan is also called income replacement or welfare because it replaces your wages while you are unable to earn an income. You can receive up to 12 weeks of income replacement during any three consecutive months.
Most disability income plans replace your welfare plans. These plans are typically available only to people with a lifetime of income support. Emergency room visits are benefits provided to you if you are in need of immediate medical care following a covered occurrence. In most cases, you must visit an emergency room within the scope of your plan.
Your plan must provide coverage within 30 days of the covered occurrence. Your plan must specify that it provides a benefit within two hours of the hospital having been contracted to provide such care. Preexisting conditions are important terms in many insurance policies because they define the conditions for which a plan will pay.
These may not be covered under your plan. If a condition is considered a pre-existing condition, you will be required to pay a higher premium than if your condition was new. Other important terms in health insurance include chronic illness benefits and age-related benefits.
A chronic illness is a term used to describe diseases or conditions for which a person has received universal or family health insurance coverage and has not contracted an acute illness. For this reason, you cannot use chronic illness benefits to replace acute illness coverage.
Chronic illnesses include heart disease, cancer, diabetes, asthma, Parkinson’s disease, bone disorders, and gastrointestinal disorders. Age-related benefits are limited to the age of the applicant, and the policy will not cover past age 65.
A benefit is a payment made to the insured upon diagnosis or recovery of the condition for which the policy was purchased. While most policies require the individual to undergo a certain number of diagnostic tests, a benefit can also be determined by the doctor’s opinion as to what treatment would best cure the ailment.
In the case of cancer, the type of treatment received is a factor in deciding what benefit is paid. One important point to remember is that the payment for a benefit is halved for each month that the applicant remains in the hospital. If the applicant is in the hospital for less than a month, the payment does not apply.
While most policies require hospitalization, some do allow outpatient treatment. The above are only some important terms in health insurance. They are important for anyone who purchases an individual or family plan.
If you are not familiar with some of these terms, be sure to talk to a licensed agent. An agent can explain the important terms of health insurance and help you understand how the plans work.