 | Deductible The deductible refers to the amount of money
that the insured would need to pay before any benefits from the
health insurance policy can be used. This is usually a yearly amount
so when the policy starts again, usually after a year, the
deductible would be in effect again. Some services, like doctor
visits, may be available without meeting the deductible first. |
| Co-insurance This is the amount that would need to be
paid by the insured before the insurance pays and in addition to the
deductible. Some health insurance plans will let the insured use
some services with just the coinsurance payment, like visiting the
doctor, even before the deductible is met. |
| Co-payments This is another term used for, or in place
of, coinsurance. |
| Lifetime Maximum This is the most amount of money the
health insurance policy will pay for the entire life. Pay attention
to individual lifetime maximums and family lifetime maximums as they
can be different. |
| Exclusions The exclusions are the things that the
insurance policy will not cover. |
| Pre-existing Conditions This is something someone had
before obtaining the insurance policy. Some plans will cover
pre-existing conditions while others may completely exclude them
and, in addition, some health insurance plans will cover
pre-existing conditions after a certain time period. |
| Waiting Period This is the time one would have to wait
until certain health insurance coverages are available. |
| Coordination of Benefits If the insured has available two
or more sources that would cover payment for certain conditions,
such being under a spouse's insurance plan along with their own, the
insurance company would not pay double benefits. In this case the
health insurance company would coordinate benefits to make sure each
plan pays a portion of the service. |
| Grace Period This is the amount of time one has to pay
their health insurance premium after the original due date and
before insurance coverage would be canceled. In Florida this is 31
days. |
| Guaranteed Renewable The policy is guaranteed to be
renewed as long as premiums are paid on time. Rates can only be
increased for all policies of the same class. You will not be
singled out for a rate increase regardless of claims filed. |
| A.M. Best Rating Rating service that determines an
insurance company's financial strength. |
