GRADED A
Health Insurance - ANSWER-offset risk of disability or prolonged illness
2 ways to purchase health insurance - ANSWER-group plan & individual plan
2 perils of health insurance - ANSWER-sickness & accident
2 kinds of losses in health insurance - ANSWER-medical bills & lost income
2 types of health insurance policies - ANSWER-medical expense policies & disability income
policies
Medical Expense Policies pay: - ANSWER-the doctors, nurses, hospitals
Disability Income Policies pay: - ANSWER-insured as replacement check
Medical Expense - ANSWER-Which Health Insurance policy?
-whole family covered
-paid immediately
- no guaranteed premiums (adjustable)
- dollar deductible
Disability Income - ANSWER-Which Health Insurance Policy?
- wage earner covered
- paid monthly or bi-weekly according to paychecks
- guaranteed premiums
- deductible = elimination period
Elimination Period - ANSWER-time without benefits
Deductible - ANSWER-Amount you must pay before you begin receiving any benefits from your
insurance company
Blue Cross/Blue Shield - ANSWER-Prepaid medical benefits for "subscribers" @ approved
facilities; many non-profit.
, Health Maintenance Organization (HMO) - ANSWER-an organization that provides
comprehensive medical care to subscribers for a fixed fee
-early treatment
-preventive medicine
- out-patient treatment
Preferred Provider Organization (PPO) - ANSWER-a group of doctors and hospitals that agree to
provide health care at rates approved by the insurer
- fee-for-service basis
Managed Care - ANSWER-Primary care physicians acting as gate keepers
Preventive Care - ANSWER-alternatives to hospitals (surgical centers & hospices)
High Deductible Health Plan (HDHP) - ANSWER-A health insurance policy that requires the
policyholder to pay more out-of-pocket medical expenses but usually has lower premiums than
traditional health insurance plans.
consumer-driven health plan (CDHP) - ANSWER-a type of managed care in which a high-
deductible, low premium insurance plan is combined with a pretax savings account to cover out-
of-pocket medical expenses
Health Reimbursement Account (HRA) - ANSWER-an account into which employers place
contributions that employees can use to pay for qualified medical expenses. Usually combined
with a HDHP.
Insuring Clause - ANSWER-A general statement that identifies the basic agreement between the
insurance company and the insured, usually located on the first page of the policy.
Consideration Clause - ANSWER-Policy owner's legal consideration, statements in the
application and the premium paid
Noncancellable Policies - ANSWER-right to keep it, price guaranteed, expensive
guaranteed renewable Policies - ANSWER-keep it until age 65, adjusted price
Conditionally Renewable Policies - ANSWER-company has the right to refuse renewal
Optionally Renewable Policies - ANSWER-company's option to refuse (non-discriminatory)
Term (nonrenewable) Policies - ANSWER-can not be renewed
Cancellable Policies - ANSWER-company can cancel at any time with 5 days notice