UNIT 12 Flashcards
ACCIDENT
Unintentional bodily injury caused by an unforeseen event
SICKNESS
A need for medical care due to a cause other than an accident
Pre-existing Condition
Is an illness or disease that existed before an individual’s health insurance went into effect.
HOSPITAL/MEDICAL EXPENSE COVERAGE
helps pay doctor and hospital bills. It includes coverage for diagnostic and treatment-related expenses such as lab tests, x-rays, and medical supplies. Many medical expense plans also cover the cost of prescription drugs.
DISABILITY INCOME INSURANCE
pays a stated amount of income to the insured when an accident or sickness leaves them unable to work for an extended period. While medical expense coverage pays doctor and hospital bills, disability income insurance provides money to pay other bills.
DENTAL EXPENSE INSURANCE
Is similar to medical expense coverage in the respect that it helps to pay dental bills. Coverage is generally provided for routine dental care such as cleanings, fillings, crowns, root canals, and braces.
LONG TERM CARE INSURANCE
Provides coverage for medical and non medical care for individuals with;
- chronic illnesses
- cognitive impairment
- difficulty performing activities of daily living, such as bathing, dressing, eating, toileting, transferring, or continence.
THESE ARE THE FEDERAL HEALTH INSURANCE PROGRAMS
- TRICARE- for active duty and retired military personnel
- Veterans Benefits- for discharged military service members
- Medicare- healthcare primarily for senior citizens and recipients of SS disability
- Medicaid- healthcare for individuals and families who are or become poor
- Social Security Disability- for eligible individuals who become totally and permanently disabled.
LIMITED PLANS
Limited Perils: limited benefit plans cover losses that arise only from one peril or one type of peril, or which occur relative to a specific situation or location.
Limited Benefits : amounts paid by limited benefit plans are typically much smaller and often restricted to stated amounts.
Notice to Proposed Insured: To assure that insureds understand the limited nature of the coverage they are buying, states require these policies to contain a prominent notice on their first page stating that the coverage provides only limited benefits.
ACCIDENT ONLY
policies only cover accidents as a peril, and exclude any type of sickness or disease. Consequently, the premiums are smaller than policies that cover both illnesses and injury.
SPECIFIED OR DREAD DISEASE
these policies were originally developed to cover one or one type, of catastrophic illness specified in the policy such as cancer or heart disease. Today these policies may cover a number of life-threatening diseases or serious conditions including stroke, coma, liver failure, kidney failure and paralysis as well as the need for organ or bone marrow transplants.
HOSPITAL INDEMNITY
plan pays a flat dollar amount as a daily benefit for each day that the insured is hospitalized as an inpatient. The payment is made directly to the insured, not to the hospital.
CREDIT DISABILITY INSURANCE
When retailers or lenders extend credit for a large purchase, they often require the consumer to have credit disability insurance to secure the loan. If the consumer (debtor) becomes disabled, the policy’s benefit is paid to the creditor (lender) to pay off the loan.
BLANKET COVERAGE
is a type of group insurance where the group members are identified as all the persons engaged in a similar activity, such as employees at a company picnic, passengers on an airplane, players or spectators at a sporting event, or students while they are on school grounds.
PRESCRIPTION DRUGS
can be included in a medical expense plan, added as a supplement to a medical expense plan, or issued as a stand-alone coverage.
