The following international health insurance glossary will help guide you with general terms related to insurance policies. However, they should not be directly interpreted as part of any one policy or how they are defined by a particular insurer. You should read your individual policy and consult with each insurer or agent to determine how each term applies to any specific insurance product you are considering.
Accidental Death and Dismemberment (AD&D)
For those that die or experience specific catastrophic injuries in accident (not illness), such as loss of limb(s) or vision, this type of policy will pay a set amount. It is customary for the amount paid to be limited to that set amount regardless of other policies that the insured may hold with the insurer. Over insurance can result in the return of excess premiums paid.
The period during which your insurer will pay for medical treatments for a specific injury or illness as specifically defined in your international health insurance policy.
After the deductible is covered, there often is a percentage of costs paid by the insurer and then the remaining percentage must be paid by you (the insured).
An out-of-pocket fee you pay when you see providers and/or medical facilities. The Co-pay often varies depending upon the service and/or provider you are using. For instance, the co-pay for a visit to a primary care physician is often different than what it costs to see a specialist, visit the emergency room, or have a procedure at an outpatient facility.
The amount of money you must pay "out of pocket" before the insurer will pay expenses covered under the policy.
Elimination Period (sometimes called a Waiting Period)
The period between the onset of a disability and when benefits actually start to be paid. In some plans, there may be a two week elimination period in each benefit period.
The most an insured will pay for medical expenses in a given year.
Medical Maximum, Annual
The absolute most your insurer will pay all of your medical expenses in a given year. It can be a set amount or, in some instances, unlimited.
Medical Maximum, Lifetime
The absolute most your insurer will pay all of your medical expenses over the course of you life under your policy. It can be a set amount or, in some instances, unlimited.
An injury or illness that existed prior to being covered by an insurance policy. This can include conditions that received treatments in the past, or can also mean an illness or injury that the insured knew about, or experienced enough symptoms such that any reasonable person would conclude that medical treatment was necessary.
Period of time between when an employee is hired and when the employer will cover them with a group health insurance plan. More generally, it can also mean the time between when any insurance policy is approved and when coverage actually starts.
The process used by an insurer to determine the level of risk posed by an individual, business or some other entity that has submitted an insurance application.
Period of time between when a policy begins and when benefits are paid/received. If you let your insurance lapse due to non-payment of premiums, it can also be a period of time (often 10 days) before sickness coverage will be in force.
Worldwide Coverage, Including the U.S.A.
International insurance that covers the costs of treatments outside of the U.S.A., as defined in the policy, AND ALSO services provided in the United States of America.
Worldwide Coverage, Excluding the U.S.A.
International insurance that covers the costs of treatments outside of the U.S.A., as defined in the policy, BUT NOT services provided in the United States of America.