Travel Medical Insurance Glossary
Visitor Health Insurance USA
Insurance Glossary of Terms used in Visitors Health Insurance, Visitors Medical Insurance, Travel Health Insurance, Travel Medical Insurance
Travel Medical Insurance Glossary provides general descriptions of commonly used terms in international travel medical insurance industry. It should be noted that there are differences between plans and that they all do not function in the same way. Please refer to individual insurance policy brochures and/or policy/certificates of insurance for complete details about each insurance plan.
Travel Health Insurance Glossary
Visitor Insurance Plans & Coverage
- Visitors Insurance – For visitors to USA or international travelers, ideal option for relatives or parents visiting USA.
- Global Health Insurance – For expatriates, worldwide residents or workers.
- International Student Insurance – For foreign students studying in America or outside home country.
- Group Travel Insurance – For groups of five or more visiting USA or traveling across borders.
- Multi Trip Insurance – Annual travel medical insurance plan for business travelers or globetrotters.
- Immigrant Insurance – For immigrant visa holders or new immigrants on green cards.
- J1 Visa Insurance – For exchange visitors as cultural program participants, au pairs, or research scholars, etc.
- Schengen Visa Insurance – For travel to Europe as tourist on vacation with Schengen visa.
- Trip Cancellation Insurance – For protection of trip costs for international travelers, vacationers, or cruise travel.
Need info on other international travel medical and health insurance plans, please contact us.
Accidental Death and Dismemberment:
An insurance policy which pays a specified amount or a specified multiple of the insured’s benefit if the insured dies, loses his/her sight, or loses two limbs due to an accident.
A contract offered on a “take-it-or-leave-it” basis by an insurer, in which the insured’s only option is to accept or reject the contract. Any ambiguities in the contract will be settled in favor of the insured.
The tendency of risks with higher probability of loss to purchase and maintain insurance more often than the risks who present lower probability.
An individual who is licensed to sell, negotiate, or effect insurance contracts on behalf of an insurer
A contract in which participating parties exchange unequal amounts. Insurance contracts are aleatory in that the amount the insured will pay in premiums is unequal to the amount the insurer will pay in the event of a loss.
AM Best Rating:
The A.M. Best Company, is considered the most authoritative source of Insurance company
information. The company provides comprehensive data to insurance professionals. Founded in 1899 by Alfred M. Best, A.M. Best
is the world’s oldest source of insurance company ratings and information. Its Best’s Ratings are the industry’s standard measure of insurer financial performance.
Please note these ratings are assigned to usually the insurance underwriters of the policies you purchase and not to the policy or the policy administrator or the insurance agent.
Following are various AM Best ratings:
A+ : Superior
A : Excellent
A- : Excellent
B++: Very Good
B+ : Very Good
B : Fair
B- : Fair
C+ : Marginal
C : Weak
C- : Weak
D : Poor
E : Under Regulatory Supervision
F : In Liquidation
S : Rating Suspended
Person(s) designated by the insured(s) that would receive the proceeds of an insurance policy upon death of the insured. You would typically assign a beneficiary at the time of completing the policy application.
Benefit Period is the maximum time period up to which the plan will pay benefits for any one eligible condition. Some policies have a 12 month while others have a 6 month benefit period; usually this period can extend beyond the date of policy expiration.
A booklet that describes insurance policies and concepts, and provides general information to help an applicant make an informed decision.
Certificate of Authority:
A documents that authorizes a company to start conducting business and specifies the kind(s) of insurance a company can transact. It is illegal for an insurance company to transact insurance without this certificate.
Certificate of Coverage:
A statement of coverage, also known as a Certificate of Insurance, that an individual receives when insured under a group contract. The certificate serves as proof of insurance, and outlines benefits and provisions.
Request by the insured(or his/her provider) to an insurance company to pay for services obtained from a health care provider. The claim is usually submitted in a pre-determined format or a claim form.
After paying the deductible, percentage or amount of covered expenses that the insured pays.
For example, an insurance policy brochure may mention that the policy will pay 80% of the first $5,000 and 100% thereafter of the usual and customary charges;
In some health insurance plans, it is also called “co-payment”.
e.g., Suppose you buy insurance policy with $50,000 policy maximum, $250 deductible per policy period and 80/20 co-insurance for the first $5000 and 100% coverage thereafter. Suppose you incur covered expense of $10,250. You pay first $250 deductible; then out of the remaining $10,000 covered expenses, you pay 20% of the first $5000 (i.e., $1000); the insurance policy pays for the remaining expenses (i.e. $9,000).
That means, you pay $250 + $1000 = $1250 total; and insurance company pays $4000 + $5000 = $9000.
Common carrier AD&D beneficiary:
If the insured person gets into an accident(while in plane for example), either loses hand, foot, eye etc. or dies, the insurance company will pay money. You should specify enter the name of the relative to whom that money should go to (in case of death) as ‘Common Carrier AD&D Beneficiary’. That is usually close relative like son, daughter, son-in-law etc. If you are buying insurance for your mother and father both, please do not put any of their names in the beneficiary. This question is for who should that money go to in case both die.
The binding force in a contract that requires something of value to be exchanged for the transfer of risk. The consideration on the part of the insured is the representations made in the application and the payment of premium, the consideration on the part of the insurer is the promise to pay in the event of loss.
Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985:
The US law that provides the insured the continuation of group health care benefits for the insured for up to 18 months if he/she terminates employment or is no longer eligible, and for the insured’s dependents for up to 36 months in cases of loss of eligibility due to death of the insured, divorce, or attainment of the limiting age.
A written and/or oral statement regarding a consumer’s credit, character, reputation, or habits collected by a reporting agency from employment records, credit reports, and other public sources.
A predetermined flat fee that the insured pays for healthcare services, in addition to what the insurance covers. Copay is usually not specified in percentage of the total healthcare cost. e.g., you pay $10 for a visit to the doctor’s office, no matter how much the doctor’s office visit charge is.
In most plans, insurance coverage can be purchased in the combination of monthly and/or 15 days increments to suit your needs. e.g., for a trip of 3.5 months, you can choose 3 monthly increments and one 15 days increment. Effective date for insurance coverage can be the date of departure from home country, or it can be any other later date specified by insured. It is wise to have the insurance effective date same as the date when you depart from home country for the destination and end date same as the date you arrive back in the home country so that you will be covered for any medical emergencies(for covered expenses) even during your journey.
Amount to be paid by the insured person before the insurance company begins to pay for the covered expenses. Deductible may be either per sickness/injury or once per policy period or once per year depending upon the insurance policy you purchase. You will not get receive any reimbursement later from insurance company for the deductible you pay.
e.g., Let us consider that you have purchased an insurance policy with a $50,000 policy maximum, $250 deductible per policy period and 80/20 co-insurance.
Suppose you incur a covered expense of $10,250; then the insurance company will pay the covered expenses according to policy terms after you make a a payment of the deductible (i.e. $250).
Denial of claim:
Refusal by an insurance company to honor a a request by an insured (or his/her healthcare provider) to pay for healthcare services. This would usually be due to pre-existing conditions.
A federal requirement that employers who have 25 or more employees, who are within the service area of a qualified HMO, who pay minimum wage, and offer a health plan, must offer HMO coverage as well as an indemnity plan.
Coverage for emergency medical evacuation to the nearest qualified medical facility or the country of residence, as determined by the insurance company; expenses for reasonable travel and accommodations resulting from the evacuation; and the cost of returning to either the country of residence or the country where the evacuation occurred, up to reasonable maximum limit.
Emergency reunion coverage for certain maximum amount, and for certain maximum duration such as 15 days, for the resonable travel and lodging expenses of a relative or friend during an emergency medical evacuation: generally either the cost of accompanying the insured during the evacuation or traveling from the country of residence to be reunited with the insured.
Extension of Benefits:
A provision that allows coverage to continue beyond the policy’s expiration date for employees who are not actively at work due to disability or who have dependents hospitalized on that date. This coverage continues only until the employee returns to work or the dependent leaves the hospital.
Fair Credit Reporting Act:
A federal law that established procedures that consumer-reporting agencies must follow in order to ensure that records are confidential, accurate, relevant and properly used.
Fraternal Benefit Societies:
Life or health insurance companies formed to provide insurance for members of an affiliated lodge, religious organization, or fraternal organization with a representative form of government.
A period of time, usually required by law, during which a policy owner may inspect a newly issued individual life or health insurance policy for a stated number of days and surrender it in exchange for a full refund of premium if not satisfied for any reason.
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