Chapter 3 Flashcards
Capitation plan
Not an insurance policy but a way of spreading the cost of future treatments
Cost plus
Insured company pays for the cost of their claims in full
Day patient
A patient who is admitted to a hospital because they need a period of medically supervised recovery but does not stay overnight
Dental insurance
Covers both routine dental work and emergencies
Flexible benefits schemes
Employees can select benefits that are appropriate to them
Fully insured
Insurer carries the full financial risk in return for a known premium
Health cash plans
Pays the cost of treatment, dental and optical costs
Hospital bands
A way of rating hospital accommodations, according to the cost of the services and the care provided
Inpatient
A patient who is admitted to hospital, and who occupies a bed overnight or longer
Limited benefit policies
Restrict the monetary amounts, payable and/or frequency, at which benefits are paid under the terms of the policy
Medical savings plans
Combine medical insurance with some form of savings plan, used to fund some medical costs or the large excess
Outpatient
A patient who attends a hospital, consulting room or outpatient clinic and is not admitted as a day patient or inpatient
Renewal
Annual reviewing process
Risk share
Premium is determined at the commencement of the policy, taking into account the expected level of claims for the company
Statement of Best Practices
Sets out definitions and information for insurers which members of the ABI must comply with
