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Affordable Health Insurance

Health Insurance Glossary

Age Limits: Stipulated minimum and maximum ages below and above which an insurer will not accept applications or may not renew policies.

Benefit: The amount payable by the insurance company to a claimant, assignee, or beneficiary under each coverage.

Cancelable: A health insurance contract that may be canceled during the policy term by the insurer or insured.

Claim: A request for payment for a loss which may come under the terms of an insurance contract.

Concealment: Deliberate failure of an insurance applicant to reveal a material fact to the insurer.

Conditions: Provisions inserted in an insurance contract that qualify or place limitations on the insurer's promise to perform.

Coverage: The scope of protection provided under a contract of insurance; any of several risks covered by a policy.

Covered Expenses: Hospital, medical, and miscellaneous health care expenses incurred by the insured that entitle him or her to a payment of benefits under a health insurance policy. Found most often in connection with major medical plans, the term defines, by either description, reasonableness, or necessity to specify the type and amount of expense which will be considered in the calculation of benefits.

Dental Insurance: An individual or group plan that helps pay costs of normal dental care as well as damage to teeth from an accident.

Exclusion: Specific conditions or circumstances listed in the policy for which the policy will not provide benefit payments.

Health Insurance: A type of insurance that provides benefits as a result of sickness or injury. Includes various types of insurance such as accident insurance, disability income insurance, prescription drug insurance, medical expense insurance, accidental death insurance, and dismemberment insurance.

Individual Deductible: The amount an insured person, and each member of his or her family covered by the policy must pay before the group or individual medical insurance policy begins to pay for medical expenses.

Lapse: The termination or discontinuance of an insurance policy due to non-payment of a premium.

Policy: The legal document issued by the company to the policyholder, which outlines the conditions and terms of the insurance.

Pre-existing Condition: A physical or mental condition of an insured person which first manifested itself prior to the issuance of his or her policy, or which existed prior to issuance and for which treatment was received.

Premium: The sum paid by a policyholder to keep an insurance policy in force.

Quote: A price estimate given to potential costumers by an insurance company. A company may be legally bound to honour this quote in some jurisdictions or lines of business.

Waiting Period: The length of time employees must wait from their date of employment or application for coverage, to the date their insurance coverage goes into effect.