It’s important to understand the spectrum of options available to us concerning our healthcare and financial prospects. It also matters greatly that we have some familiarity with the specific terminology used in product and service explanations. There are words and phrases that, once explained, can make the insurance plans and opportunities they’re a part of even more comprehensible, and thus, more beneficial for the policyholder or contract holder.

What follows is a selection of health insurance words and phrases, along with their brief definitions, one might find while learning about ManhattanLife products and services. Please note: These terms are presented for informational purposes only and are not intended to supplement or act in place of official documents related to or regarding plans and policies.

agent – a term for an individual that sells insurance on behalf of another company; for example, an insurance agent.

annuity – contract between a contract holder and an insurance company wherein money is put into an account; then the contract holder or annuitant has the option to receive regular payments either immediately or in the future.

broker – another term for an individual that sells insurance on behalf of another company; for example, an insurance broker.

customized coverage – coverage tailored to an individual’s or particular employer group’s specific needs, comprised of different policy types.

deductible – usually the out-of-pocket amount that the insured must pay before the insurer begins sharing the cost.

encounter – a meeting with a healthcare provider, in which the insured receives any type of service.

enrollment – the process of signing up an eligible person to participate in a health insurance plan. This term may also mean the total number of participants in a healthcare plan.

indemnify – the act of returning someone who has sustained a loss to the position they were in before the loss occurred.

indemnity – issuing a payment or replacement to a person who has suffered a loss, be it financial or otherwise.

in-patient – an individual who has been admitted to a hospital or healthcare facility as a patient in residence.

lapse – the cancellation of a policy due to the non-payment of the premium due.

length of stay – the total length, in days, that an insured stays in a hospital or similar medical facility.

mature – this usually means when a permanent life insurance policy’s face value equals the death benefit, hypothetically for a whole or universal life product.

Medicare – a government operated and funded plan for paying hospital and other healthcare costs for those who qualify. These people are usually older than 65. Coverage is divided into Part A, which provides the compulsory hospital benefits, and Part B, a voluntary program that covers medical expenses.

out-of-pocket limit – the highest coinsurance an insured will have to pay. After this amount is paid, the insurer may cover all expenses up to the policy limit.

out-patient – a patient who does not reside in or have a bed in the hospital where he or she receives treatment.

payee – a person receiving money.

producer – an additional term for an individual that sells insurance on behalf of another company; for example, an insurance producer.

qualifying event – an event that causes the insured’s coverage; for example, a birth or a job loss.

recidivism – within the context of health insurance, this term is used to refer to the frequency with which an insured returns to the hospital for an in-patient treatment due to the same ailment.

rider – a provision added to a policy to increase benefits like adding coverage for another condition or event. Examples include a sports injury rider or critical illness rider.  

term – the length of time for which a policy is valid.

underwriter – a title given to a person specially trained to assess risks and establish rates and coverage amounts for them.

waiting period – also known as the elimination period; a period of time stated in a policy which must pass before some or all coverages go into effect.

A few of the terms exhibited here would be worth a lot of points in Scrabble. In fact, the next time you attend a game night with friends and you’re looking to disappoint them, give these terms the old college try. But, more significantly, these definitions, while not all encompassing and dependent upon context, should be useful. To have the healthcare or monetary outlook we really want, one must first be equipped with a strong knowledge of what is being offered. This helps imbue us with additional comfort and confidence moving ahead.

Keep reading with our recent blog article titled Upsides to Aging: 10 Reasons Getting Older is Great. Clever and replete with positivity, this article will have you absorbed in no time.

Find all of our blog articles on our main ManhattanLife Blog page.

 

Works Cited

Samaroo, Melissa. The Complete Dictionary of Insurance Terms. Ocala, Atlantic Publishing Group Inc., 2011.