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Health Benefit Indemnity Insurance Definitions

Accident

An unexpected, unforeseen occurrence that may result in bodily Injury.

Accident Medical Benefits

Defined amounts which provide lump-sum cash payments to cover expenses resulting from a medical related accident.

Accident Insurance

Supplemental medical insurance that pays a set amount when you have a covered accident to cover expenses that may be incurred.

Claim Provisions

Clauses within an insurance contract that set forth the procedure to be followed in the submission and administration of claims.

Critical Illness Benefits

Defined coverage amounts to be paid in lump-sum cash payments to cover specific life-threatening conditions, if the diagnosis occurs during the policy period.

Critical Illness Insurance

Supplemental medical insurance that pays a set amount of money to help cover bills associated with some of the most common critical illnesses that you may experience.

Emergency Room

A specified area in a Hospital which is designated for the emergency care of Sickness or Injury.

Emergency Care

Medical attention provided after the acute onset of symptoms relating to Sickness or Injury, including severe pain, which symptoms are severe enough that the lack of immediate medical attention could reasonably be expected to result in any of the following: Health would be placed in serious jeopardy;
Bodily function would be seriously impaired;
or There would be serious dysfunction of a bodily organ or part.

Exclusions

Defined risks that are specifically not covered by an insurance policy or contract.

First Dollar Coverage

An insurance policy feature that provides full coverage for the entire value of a loss without a deductible or other cost sharing.

Fixed Indemnity Insurance

A fixed-dollar plan that pays a predetermined amount on a per-period or per-incident basis, regardless of the total charges incurred.

Hospital

An institution operated by law for the care and treatment of injured or sick persons; has organized facilities for diagnosis and surgery or has a contract with another hospital for these services; and has 24-hour nursing service.

Hospitalization

Care in a hospital that requires admission as an inpatient and usually requires an overnight stay. An overnight stay for observation could be outpatient care in some situations.

Hospital Inpatient Care

Care of patients whose condition requires admission to a hospital.

Hospital Outpatient Care

Care in a hospital that usually doesn’t require an overnight stay.

Health Benefit Indemnity Insurance

Health insurance plan that offers financial protection for commonly needed medical services, including hospital and doctor benefits. When you experience a covered medical event, health benefit indemnity insurance pays a set fee, directly to you or a provider designated by you.

Hospital Benefits

The hospital limits stated within the Hospital portion of a health benefit indemnity insurance plan.

Hospital Insurance

A plan which provides coverage for hospital confinement due to illness, accidents, intensive care and recovery.

Ours: This benefit pays fixed amounts upon the diagnosis of a covered critical condition such as cancer or a heart attack.

Inpatient Care

Health care that you get when you're admitted as an inpatient to a health care facility, like a hospital or skilled nursing facility.

Illness

Sickness or disease of a Covered Person.

Injury

A bodily injury sustained which Is directly caused by an accident, independent of all other causes.

Intensive Care Unit

A specialized department within a Hospital that provides advanced and highly specialized care to medical or surgical patients, whose conditions are life-threatening and require comprehensive care and monitoring.

Plan Provisions

An insurance contract that defines policy details such as coverage periods, exclusions, riders, start dates, and other important information.

Preventive care

Care you receive to prevent illnesses or diseases. Providing these services at no cost is based on the idea that getting preventive care, such as screenings and immunizations, can help you and your family stay healthy.

Supplemental Medical Insurance

Supplemental medical insurance adds a layer of protection to your medical insurance by paying a set amount when you experience an accident or critical illness covered by the plan. Supplemental medical insurance plans are designed to work as a complement to your major medical insurance (Obamacare or Short Term Health Plans) or Health Benefit Indemnity Insurance plans.

Supplemental Health Products

By including additional insurance and services, supplemental health products add value to your overall health care benefit package. Supplemental health products are designed to be purchased in addition to a major-medical health plan (such as a short term or an ACA/Obamacare health plan) or a health benefit indemnity insurance plan and are categorized in two basic types: supplemental health insurance or non insurance supplemental health products.