Insurance Concepts

A collection of vocabulary flashcards related to key insurance concepts.

Deductible

The amount paid out of pocket by the policyholder before an insurance provider will pay any expenses.

Premium

The amount paid periodically to an insurance company for coverage.

Out-of-pocket maximum

The maximum amount a policyholder has to pay for covered services in a plan year.

Co-payment (Co-pay)

A fixed amount paid by the insured for a covered service, typically at the time of service.

Coinsurance

A percentage of the cost of a covered healthcare service that the insured is responsible for paying after the deductible is met.

Network

The facilities, providers, and suppliers your health insurer has contracted with to provide healthcare services.

Exclusions

Specific conditions or circumstances for which the policy does not provide benefits.

Pre-existing condition

A health issue that was present before the effective date of the insurance policy.

Underwriting

The process of evaluating the risk of insuring a policyholder and determining the terms and premium.

Beneficiary

The person or entity designated to receive the benefits of an insurance policy upon the occurrence of an insured event.