Health and Disability Insurance
1. Catastrophic Coverage – insurance that covers medical expenses that occur as a result of serious medical emergencies.
2. Cognitive impairment - a loss of mental capacity that requires you to have substantial supervision to maintain your safety and the safety of
others.
3. Consolidated Omnibus Budget Reduction Act (COBRA) – a federal law that enables eligible individuals to continue health coverage at their own
expense after losing their job or the relationship with the person through whose job they were insured.
4. Copayment – in health insurance, a small part of the charge for a doctor visit, paid by the insured at the time of service.
5. Cost of living adjustment - in disability insurance, a rider that prevents your benefits from losing value due to inflation.
6. Custodial care - assistance with the activities of daily living, such as bathing, eating, and dressing.
7. Daily maximum - in long-term care insurance, daily fixed amounts of coverage for various kinds of care.
8. Disability insurance – insurance that supplements lost income when illness or injury prevents the insured from working.
9. Elimination period - a clause in a disability insurance policy that specifies how soon after the disability the policy will begin to pay benefits.
10. Fee-for-service plan - a health insurance plan in which the insured shares the cost of the medical service with the insurer, usually a 20/80 ratio
after the insured satisfies the deductible.
11. Group plan – a contract under which everyone belonging to a specified group is insured.
12. Health Insurance – a plan for sharing the risk of medical costs resulting from an injury or illness.
13. Health Insurance Portability and Accountability Act (HIPAA) – a federal law that permits employees to take their health insurance eligibility
with them when they change jobs
14. Health Maintenance Organization (HMO) – a network of health care providers affiliated with, or employed by an insurer
15. High Deductible Healthcare Plan (HDHP) – a health insurance plan with lower premiums and higher deductibles than a traditional health plan
16. Home health aide - in long-term care, the person who helps the recipient bathe and dress, changes the bed, and performs other housekeeping tasks, as well as socializes and supports the individual.
17. Indemnity policy - long-term care policy that specify daily coverage amounts for various kinds of care.
18. Integrated policy - in long-term care, a policy that specifies a total dollar amount that may be spent on specified types of care, subdivided into a daily, weekly, or monthly dollar amount.
19. Internal limit - the maximum amount a health insurer will pay per day for medical treatment.
20. Law of Large Numbers – the principle of minimizing risk of financial loss by spreading the expense of paying out claims over many customers over a
period of many years
21. Long-term care insurance – insurance covering the cost of extended care of people who have difficulty with basic daily activities
22. Lifetime limit - the maximum a health insurer will pay in the insured's lifetime.
23. Managed care plan - a health insurance plan that provides comprehensive medical care to
24. Medicaid – a government medical assistance program based on need
25. Medicare – a government medical assistance program for retired and/or disabled persons
26. Medigap – any of a number of private health insurance plans designed to cover the expenses that Medicare does not
27. Own-occupation protection - extra coverage in a disability policy for those who have a highly specialized and highly paid job, such as a brain
surgeon.
28. Per claim maximum - the maximum amount of money a health insurer will pay for any single claim.
29. Physical impairment - not being able to perform without assistance two, or sometimes three, of the six basic activities of daily living.
30. Point of Service Organization (PSO) – a managed-care plan that requires a primary care physician to refer the insured to preferred providers
31. Preapproval – the requirement that health care providers receive permission from the insurer before performing non-emergency surgery or
unusual treatments
32. Pre-existing conditions – a medical condition for which a new insured has been treated recently, which may be excluded from coverage for a
specified time
33. Preferred Provider Organization (PPO) – a managed-care plan in which physicians and other providers form a network offering care at a
reduced rate
34. Preventative Care – medical care that focuses on disease prevention and health maintenance
35. Primary Caregiver - in long-term care, the person who attends to all of the recipient's medical needs.
36. Primary Care Physician (PCP) – the doctor designated by the insured to be most directly responsible for his or her care.
37. Residual benefits - disability insurance that protects you when you are able to work part-time but not full-time.
38. Total disability - not being able to perform any of the main functions of the job you held when you became disabled or of any similar job
appropriate to your education, training, and experience; some insurers require you not be able to perform any job.
39. Wavier of premium - in disability insurance, a provision saying you don't have to keep paying premiums after you are disabled for a specified
period, such as 90 days; in long-term care insurance, a provision that enables you to stop paying premiums after you become disabled for a specified
period, such as 90 days, without the policy being canceled.
1. Catastrophic Coverage – insurance that covers medical expenses that occur as a result of serious medical emergencies.
2. Cognitive impairment - a loss of mental capacity that requires you to have substantial supervision to maintain your safety and the safety of
others.
3. Consolidated Omnibus Budget Reduction Act (COBRA) – a federal law that enables eligible individuals to continue health coverage at their own
expense after losing their job or the relationship with the person through whose job they were insured.
4. Copayment – in health insurance, a small part of the charge for a doctor visit, paid by the insured at the time of service.
5. Cost of living adjustment - in disability insurance, a rider that prevents your benefits from losing value due to inflation.
6. Custodial care - assistance with the activities of daily living, such as bathing, eating, and dressing.
7. Daily maximum - in long-term care insurance, daily fixed amounts of coverage for various kinds of care.
8. Disability insurance – insurance that supplements lost income when illness or injury prevents the insured from working.
9. Elimination period - a clause in a disability insurance policy that specifies how soon after the disability the policy will begin to pay benefits.
10. Fee-for-service plan - a health insurance plan in which the insured shares the cost of the medical service with the insurer, usually a 20/80 ratio
after the insured satisfies the deductible.
11. Group plan – a contract under which everyone belonging to a specified group is insured.
12. Health Insurance – a plan for sharing the risk of medical costs resulting from an injury or illness.
13. Health Insurance Portability and Accountability Act (HIPAA) – a federal law that permits employees to take their health insurance eligibility
with them when they change jobs
14. Health Maintenance Organization (HMO) – a network of health care providers affiliated with, or employed by an insurer
15. High Deductible Healthcare Plan (HDHP) – a health insurance plan with lower premiums and higher deductibles than a traditional health plan
16. Home health aide - in long-term care, the person who helps the recipient bathe and dress, changes the bed, and performs other housekeeping tasks, as well as socializes and supports the individual.
17. Indemnity policy - long-term care policy that specify daily coverage amounts for various kinds of care.
18. Integrated policy - in long-term care, a policy that specifies a total dollar amount that may be spent on specified types of care, subdivided into a daily, weekly, or monthly dollar amount.
19. Internal limit - the maximum amount a health insurer will pay per day for medical treatment.
20. Law of Large Numbers – the principle of minimizing risk of financial loss by spreading the expense of paying out claims over many customers over a
period of many years
21. Long-term care insurance – insurance covering the cost of extended care of people who have difficulty with basic daily activities
22. Lifetime limit - the maximum a health insurer will pay in the insured's lifetime.
23. Managed care plan - a health insurance plan that provides comprehensive medical care to
24. Medicaid – a government medical assistance program based on need
25. Medicare – a government medical assistance program for retired and/or disabled persons
26. Medigap – any of a number of private health insurance plans designed to cover the expenses that Medicare does not
27. Own-occupation protection - extra coverage in a disability policy for those who have a highly specialized and highly paid job, such as a brain
surgeon.
28. Per claim maximum - the maximum amount of money a health insurer will pay for any single claim.
29. Physical impairment - not being able to perform without assistance two, or sometimes three, of the six basic activities of daily living.
30. Point of Service Organization (PSO) – a managed-care plan that requires a primary care physician to refer the insured to preferred providers
31. Preapproval – the requirement that health care providers receive permission from the insurer before performing non-emergency surgery or
unusual treatments
32. Pre-existing conditions – a medical condition for which a new insured has been treated recently, which may be excluded from coverage for a
specified time
33. Preferred Provider Organization (PPO) – a managed-care plan in which physicians and other providers form a network offering care at a
reduced rate
34. Preventative Care – medical care that focuses on disease prevention and health maintenance
35. Primary Caregiver - in long-term care, the person who attends to all of the recipient's medical needs.
36. Primary Care Physician (PCP) – the doctor designated by the insured to be most directly responsible for his or her care.
37. Residual benefits - disability insurance that protects you when you are able to work part-time but not full-time.
38. Total disability - not being able to perform any of the main functions of the job you held when you became disabled or of any similar job
appropriate to your education, training, and experience; some insurers require you not be able to perform any job.
39. Wavier of premium - in disability insurance, a provision saying you don't have to keep paying premiums after you are disabled for a specified
period, such as 90 days; in long-term care insurance, a provision that enables you to stop paying premiums after you become disabled for a specified
period, such as 90 days, without the policy being canceled.