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Following is the general description of commonly used terms in international visitor health insurance. It is important to know that all plans do NOT work in the same way. Please refer to the individual insurance policy brochure and/or policy/certificate of insurance for complete details about each insurance plan.
Notes: In this document, wherever the term insurance company is mentioned, it actually means either the underwriting insurance company or the insurance administrator as appropriate. Also, wherever the term insurance policy is mentioned, it actually means either the insurance policy or certificate of insurance as appropriate.
- Accident medical expense
- Accidental Death & Dismemberment(AD&D)
- Amateur sailboat racing
- AM Best rating
- Aroma therapy
- Assistant surgeon
- Bedside visit
- Benefit period
- Carrier / Insurance Company / Underwriter
- Certain Illnesses
- Certificate of coverage
- Chemical dependency
- Child wellness
- COBRA(Consolidated Omnibus Budget Reconciliation)
- Collision damage waiver
- Common carrier
- Common carrier AD&D beneficiary
- Concierge services
- Consult physician
- Coverage period
- Credit card protection
- Crisis Response
- CT Scan
- Denial of claim
- Dental - Accidental related emergency
- Dental - Acute, unexpected pain
- Diagnostic X-ray
- Durable medical equipment
- Emergency cash transfer
- Emergency evacuation
- Emergency reunion
- Emergency room visit
- Extended care facility
- Flight accident
- Hazardous sports coverage
- Herbal therapy
- Home nursing care
- Hospice care
- Hospital indemnity
- Hospital room and board
- Hotel overbooking
- ID theft protection
- Individual policy
- Initial orthopedic prosthesis/ Brace
- Inpatient labs/x-rays
- Intensive care unit
- Lifetime maximum
- Live messaging
- Local ambulance
- Lost luggage
- Magnetic therapy
- Massage therapy
- Mental/Nervous care
- MRI: Magnetic Resonance Imaging
- Natural disaster benefit
- New born care
- Out of pocket maximum
- Outpatient lab tests
- Outpatient surgery
- Outpatient surgical facility
- Outpatient treatment
- Outpatient x-rays
- Personal Liability
- Pet care home alone
- Pharmacy drug card
- Physical therapy
- Physician visit
- Policy duration
- Policy maximum
- Pre-admission tests
- Pre-existing conditions
- Prescription drugs
- Preventive care
- Primary care
- Private duty nurse
- Professional services related to inpatient maternity expenses
- Prosthetic devices
- Radiation therapy
- Repatriation of remains
- Return of minor children
- Sickness medical expense
- Specialist visit
- Sports injuries
- Substance abuse
- Supplemental accident
- Surgical intervention consultation
- Term life insurance
- Travel delay
- Travel document replacement
- Trip cancellation
- Trip interruption
- Urgent care
- Vehicle accident
- Vitamin therapy
Deliberate ending of a pregnancy by medical intervention.
Covered expenses incurred as a result of an injury which occurs during the covered trip.
Also includes expenses for emergency dental treatment for injury to sound natural teeth up to a certain amount that depends upon the insurance plan.
Principal sum paid in case of accidental loss of life or accidental loss of two members. Usually 50% of the principal sum is paid in case of accidental loss of one member. "Member" means hand, foot or eye.
Practice of inserting needles into the body to reduce pain or induce anesthesia. It is a family of procedures involving the stimulation of anatomical locations on or in the skin by a variety of techniques.,
Acupuncture has been found useful particularly in chronic headaches, migraine.
A company that administers the insurance policies including but not limited to policy branding, customer support, benefits approval, claims processing, preferred provider coordination etc.
You will never have to deal with the underwriter as everything for you will be handled by the administrator.
In some plans, claims administrator and plan administrator may be different.
The non-professional pursuit of racing sailboats in coastal waters (no greater than 12 miles from any shoreline).
A.M. Best Company, The Insurance Information Source, offers comprehensive data to insurance professionals. Founded in 1899 by Alfred M. Best, A.M. Best is the world's oldest and most authoritative source of insurance company ratings and information. A.M. Best's Ratings are the industry's standard measure of insurer financial performance.
Following are various AM Best ratings:
|E||Under Regulatory Supervision|
More information about AM Best Ratings.
A nurse or a technician trained to administer anesthetics.
Anesthetic: A substance that causes lack of feeling or awareness. A local anesthetic causes loss of feeling in a part of the body. A general anesthetic puts the person to sleep.
Epidural Anesthetic: An anesthetic injected into the epidural space surrounding the fluid-filled sac (the dura) around the spine which partially numbs the abdomen and legs.
The Apostile is a specific form of Authentication that is prepared pursuant to an international treaty the "Convention de le Haye du 5 octobre 1961" also known as "The Hague Convention Abolishing the Requirements of Legalization for Foreign Public Documents." The convention eliminates the need for authentication above the level of the Secretary of the State and is only accepted by countries that have signed the treaty. The country in which the documents will be used determines the type of certificate that this office will attach to the original. If you would like more information on the Apostile, you can consult the U.S. State Department's web site at: travel.state.gov/content/travel/en/legal-considerations/judicial/authentication-of-documents/apostille-requirements.html. If you need to know which countries have signed the treaty, you can find that information on the same web site at: travel.state.gov/content/travel/en/legal-considerations/judicial/authentication-of-documents/office-of-authentications.html. You may also consult the web site of the Hague Conference on International Private Law at: www.hcch.net. This web site provides the text and lists of the signatories of the various Hague Conventions. The "Convention Abolishing the Requirement of Legalization for Foreign Public Documents" is the treaty which governs the issuance of the Apostile.
Aroma therapy is derived from the ancient practice of using natural plant essences to promote health and well being. It consists of the use of pure essential oils obtained from a wide assortment of plants, which have been steam distilled or cold-pressed from flowers, fruit, bark and roots.
Aroma therapy can help ease a wide assortment of ailments; easing aches, pains, and injuries, while relieving the discomforts of many health problems.
Aroma therapy also acts on the central nervous system, relieving depression and anxiety, reducing stress, relaxing, uplifting, sedating or stimulating, restoring both physical and emotional well being.
Assistant Surgeon is a physician who assists a surgeon in the operating room.
If the Covered Person is Hospital Confined due to an Injury or Sickness for more than several days while traveling outside his/her Home Country, the Insurer will pay up to some maximum benefit for the cost of one economy round trip air fare ticket to, and the hotel accommodations in, the place of the Hospital Confinement for one person designated by the Covered Person. With respect to any one trip, this benefit is payable only once for that trip, regardless of the number of Covered Persons on that trip.
Please look at the individual plan brochure for more details.
Person(s) designated by the insured(s) that would receive the proceeds of an insurance policy upon death of the insured.
If you are applying for your parents, you should usually write your name. If you are applying for your in-laws, you should usually write your spouse's name. Please don't write the name that is already covered in the application. If you are applying for both parents, do not write your father's or mother's name in this field. Of course, you can name anyone you prefer as the beneficiary.
Amount an plan pays to a claimant, assignee or beneficiary when the insured suffers a covered loss.
If a covered injury or illness requires continuing treatment after the Period of Coverage expires, the benefit period may provide continued coverage. When the certificate expires, the Company will review the date of initial treatment for the covered injury or illness and will begin counting the benefit period from that date.
Carrier / Insurance Company / Underwriter:
Insurance company that actually underwrites and issues the insurance policy. The term refers to the fact that the company carries (or assumes) certain risks for the policyholder.
The following illnesses which exist, manifest themselves, or are treated or have treatment recommended prior to or during the first 180 days of coverage from the initial effective date are considered pre-existing conditions under the plan, and are subject to the waiting period and other limitations of coverage described: tonsillectomy, disc disease, adenoidectomy, hemorrhoids or hemorhoidectomy, disorders of the reproductive system, hysterectomy, hernia, gall stones or kidney stones, any condition of the breast, and any condition of the prostate.
This list varies by insurance company. e.g., Citizen Secure from HCCMIS also excludes of sebaceous glands, acne, other acne, sebaceous cyst, seborrhea, unspecified disease of the sebaceous glands, moles, skin tags, hypertrophic and atrophic conditions of the skin, nervous conditions.
Please look at the brochure for the complete list of diseases in each plan.
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.
"Chemical dependency" is the use of any chemical substance, legal or illegal, that creates behavioral and/or health problems, resulting in operational impairment. This term includes alcoholism and/or drug dependency that endanger the health, interpersonal relationships, or economic functions of an individual or the public health, welfare or safety. A "chemical dependency facility" is a facility whose function is the treatment, rehabilitation and prevention of chemical dependency as defined above.
Inpatient chemical dependency treatment includes inpatient treatment in a hospital setting and inpatient treatment in a free-standing facility outside a hospital. It does not include day treatment, intermediate care or transitional living, intensive outpatient treatment or outpatient treatment.
A drug therapy for cancer.
Chemotherapy is generally given in cycles: a treatment period is followed by a recovery period, then another treatment period, and so on. Usually a patient has chemotherapy as an outpatient at the hospital, at a doctor's office or clinic, or at home. However, depending on which drugs are given and the patient's general health, the patient may need to stay in the hospital for a short time.
The side effects of chemotherapy depend mainly on the drugs and the doses the patient receives. Hair loss is a major side effect.
A well-baby exam usually consists of questions the care provider will ask about your baby's general health and development, followed by a physical exam. The exam includes measurements of length, height, weight and head circumference, vital signs and a general physical examination. Special attention is paid to whether your baby has met normal developmental milestones.
Various immunizations(vaccinations) would also be generally given at the time of this exam.
Someone who practices chiropractic. Chiropractic is defined as a system of diagnosis and treatment that is based upon the concept that the nervous system coordinates all of the body's functions and holds that disease results from a lack of normal nerve function and employs manipulation and specific adjustment of body structures such as the spinal column so that pressure on nerves coming from the spinal cord due to displacement (subluxation) of a vertebral body may, it is believed, cause problems not only in the back but some distance from it as in the leg. Chiropractors therefore work to manipulate the spine with their hands to realign the vertebrae and relieve the pressure on the nerves. Chiropractic treatment is believed effective for muscle spasms of the back and neck, tension headaches, and some sorts of leg pain.
Request by the insured(or his/her provider) to an insurance company to pay for services obtained from a health care provider.
Regulations requiring an employer who employs more than 20 people to offer continued group insurance coverage to former employees for up to 18 months. If the employee dies, the employer must offer continued group health insurance coverage to widowed spouses and dependent children for up to 36 months.
After paying the deductible, percentage or amount of covered expenses that the insured pays.
When the insurance policy brochure says co-insurance is 20% or it is 80/20, it means that insurance company will pay 80% of usual and customary charges, and the insured will be responsible for remaining 20%. Usually, in many plans, there is a maximum out of pocket amount after which plan pays 100% of covered expenses, up to selected policy maximum.
In some health insurance plans, it is also called "co-payment".
e.g., Suppose you buy an insurance policy with $50,000 policy maximum, $250 deductible per policy period and 80/20 co-insurance, $1000 maximum out of pocket for co-insurance. Suppose you incur covered expense of $7250. You first pay $250 deductible. Out of $7000 covered expenses, insurance company will pay 80% for the first $5,000 expense (i.e., $4,000). You pay 20% (i.e., $1000). For the rest of $2000 expense, they will pay 100%. That means, you pay $250 + $1000 = $1250 total, and plan pays $4000 + $2000 = $6000. If you again later incur expense of, say, $3000, insurance company will pay all $3,000, as you have already satisfied your deductible and maximum out of pocket expenses.
Up to specified maximum limit, it covers cost of repairs for collision or comprehensive damage to a rental car, up to the limit of coverage, for which the car rental contract holds you responsible.
A procedure in which a long flexible viewing tube (a colonoscope) is threaded up through the rectum for the purpose of inspecting the entire colon and rectum and, if there is an abnormality, taking a biopsy of it or removing it. The procedure requires a thorough bowel cleansing to assure a clear view of the lining. Called also coloscopy.
A vehicle or service licensed to carry passengers for hire on a regularly scheduled basis.
If the insured person gets into an accident (while in plane for example), and either loses hand, foot, eye etc. or dies, the insurance company will pay the benefit amount. You should specify the name of the relative as 'Common Carrier AD&D Beneficiary' who should receive the benefit amount if the insured should die. 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 receives the money in case both die.
If you are buying insurance for your in-laws, put YOUR spouse's name there.
If you would like to enter multiple beneficiaries, you can separate them by commas.
Unless indicated otherwise, the primary insured will be deemed the beneficiary for his/her spouse and children.
Non insurance related services such as Restaurant Referrals and Reservations, Airport Transportation, Event Ticketing, Tee Times and Course Recommendations, Flower Ordering, destination information and advice, international dining recommendations and several other things.
Consult physician is a physician involved in the case by the primary physician for the purposes of an independent or specialized evaluation, when requested and approved by the attending physician.
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 the 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 the 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.
The Insurer will reimburse for loss due to unauthorized use of the Insured's credit cards, if the Insured has complied with all credit card conditions imposed by the credit card companies.
Crisis Response is a benefit that provides coverage for Ransom, Personal Belongings, and Crisis Response Fees and Expenses in case of kidnapping. This benefit may be included in a plan or it is an optional coverage (called a rider) that needs to be added when purchasing a plan.
Please refer to your plan documents for complete details.
CT scan: Computerized tomography scan. Pictures of structures within the body created by a computer that takes the data from multiple X-ray images and turns them into pictures on a screen. CT stands for computerized tomography.
The CT scan can reveal some soft-tissue and other structures that cannot even be seen in conventional X-rays. Using the same dosage of radiation as that of an ordinary X-ray machine, an entire slice of the body can be made visible with about 100 times more clarity with the CT scan.
The tomograms ("cuts") for CT are usually made 5 or 10 mm apart. The CT machine rotates 180 degrees around the patient's body. The machine sends out a thin X-ray beam at 160 different points. Crystals positioned at the opposite points of the beam pick up and record the absorption rates of the varying thicknesses of tissue and bone. The data are then relayed to a computer that turns the information into a 2-dimensional cross-sectional image.
The CT scan is also known as the CAT (computerized axial tomography) scan.
A procedure in which the doctor inserts a lighted instrument called a cystoscope into the urethra (the tube that carries urine from the bladder to the outside of the body) in order to look inside the urethra and bladder.
The cystoscope has lenses like a telescope or microscope. These lenses let the doctor focus on the inner surfaces of the urinary tract. Some cystoscopes use optical fibers (flexible glass fibers) that carry an image from the tip of the instrument to a viewing piece at the other end. The cystoscope is as thin as a pencil and has a light at the tip. Many cystoscopes have extra tubes to guide other instruments for procedures to treat urinary problems.
Cystoscopy may be done for any one of a number of reasons including frequent urinary tract infections; blood in the urine (hematuria); loss of bladder control (incontinence) or an overactive bladder; unusual cells that have been found in urine sample; the need for a bladder catheter; painful urination, chronic pelvic pain, or interstitial cystitis; urinary blockage such as prostate enlargement, stricture, or narrowing of the urinary tract; an unusual growth, polyp, tumor, or cancer: and a stone in the urinary tract.
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 receive any reimbursement later from insurance company for the deductible you pay.
e.g., Suppose you buy an insurance policy with $50,000 policy maximum, $250 deductible per policy period and 80/20 co-insurance, $1000 maximum out of pocket for co-insurance. Suppose you incur covered expenses of $7250, insurance company will start paying for covered expenses according to policy terms after you make initial payment of chosen deductible, $250.
Note: This is just an example of the deductible. It does not describe the benefits of all the products. Not all products provide the same benefits.
Refusal by an insurance company to honor a request by an insured (or his/her healthcare provider) to pay for healthcare services. This would usually be due to pre-existing conditions.
Any dental expenses whether it is routine checkup or preventive services, services due to urgent relief of tooth pain, constructive services (bridge, crown etc.), orthodontic services (braces etc.), periodontal services.
Benefit payable in case of accidental damage to sound natural teeth.
Benefit payable in case of an acute and unexpected pain in an emergency. This benefit should not be considered as dental insurance. If you need a dental plan, they are available on this web site under 'Dental' section.
Diagnostic X-ray - is a photographic technique which is helpful in allowing your physician to see structures inside your body and achieve a better understanding of how efficiently they are performing. The X-rays will be reviewed by a radiologist (a doctor specializing in interpreting X-rays) and discussed with your physician for diagnosis.
Durable Medical Equipment includes devices, controls, or appliances specified in the plan of care that enable the beneficiary to increase their ability to perform activities of daily living, or to perceive, control or communicate with the environment in which they live. This includes items necessary for life support, ancillary supplies and equipment necessary for the proper functioning of such items.
e.g., wheelchairs, crutches etc.
Echocardiography is a diagnostic test which uses ultrasound waves to make images of the heart chambers, valves and surrounding structures. It can measure cardiac output and is a sensitive test for inflammation around the heart (pericarditis). It can also be used to detect abnormal anatomy or infections of the heart valves.
Assistance in coordinating an emergency cash advance.
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.
Please note that there is NO medical coverage in this benefit, just the transportation.
Emergency reunion coverage for certain maximum amount, and for certain maximum duration such as 15 days, for the reasonable 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.
Visit to an emergency room. It is considered such when you go to the hospital emergency room, and you come back the same day and you are not admitted into the hospital and you are not utilizing hospital room and board.
Medical emergency is a condition that would lead a "prudent layperson" (someone with average knowledge of health and medicine) to believe that a serious medical condition existed, or the absence of medical attention would result in a threat to his or her life, limb or sight and requires immediate medical treatment or which has painful symptoms requiring immediate attention to relieve suffering.
Insureds are advised not to rush to emergency room for minor ailment such as fever or cold. Depending upon the insurance product, if it is not true emergency, you may not be covered, may be partially covered, may be subject to higher deductible or copay.
Endoscopy is a broad term used to describe the examination of the inside body using a lighted, flexible instrument called an endoscope. In general, an endoscope is introduced into the body through a natural opening like the mouth or anus. Although endoscopy can include examination of other organs, the most common endoscopic procedures evaluate the esophagus (swallowing tube), stomach, and portions of the intestine.
Healthcare services not covered by an insured's health insurance policy. This would usually be due to pre-existing conditions or due to the limitation of the insurance plan.
Also called skilled nursing.
An institution, or a distinct part of an institution, which is licensed as a Hospital, Extended Care Facility or rehabilitation facility by the state or country in which it operates; and is regularly engaged in providing 24-hour skilled nursing care under the regular supervision of a Physician and the direct supervision of a Registered Nurse, and maintains a daily record on each patient, provides each patient with a planned program of observation prescribed by a Physician, and provides each patient with active Treatment of an Illness or Injury. Extended Care Facility does not include a facility primarily for rest, the aged, Substance Abuse, Custodial Care, nursing care, care of Mental or Nervous Disorders or the mentally incompetent.
You are covered for the amount purchased for accidental death, dismemberment or loss of sight as the result of an accident while a passenger on a regularly scheduled airline flight (and in several other situations also, please see brochure of each policy for details).
100% benefit paid for loss of life, loss of both limbs, loss of sight in both eyes, loss of one limb and sight from one eye.
50% benefit paid for loss of limb, loss of sight in one eye.
Procedure of using a flexible, lighted instrument that is put through the mouth and down the esophagus to view the stomach. Tissue from the stomach can also be removed through the gastroscope.
Coverage for injuries incurred during amateur athletic activities
which are non-contact and engaged in by an insured person solely for
leisure, recreation, entertainment or fitness purposes. However,
activities not covered include amateur or professional sports or
other athletic activity which is organized and/or sanctioned, or
which involves regular or scheduled practices, games or competition.
Usually, the following hazardous activities can be included by optional sports rider at additional premium cost: scuba diving, mountain climbing (up to 4500 meters or where ropes or guides are normally used), jet, snow and water skiing, snowboarding, sky diving, amateur racing, piloting an aircraft, bungee jumping and spelunking.
The use of plants or plant extracts for medicinal purposes (especially plants that are not part of the normal diet).
Services, provided by a Home Health Care Agency and supervised by a Registered Nurse, which are directed toward the personal care of a patient, provided always that such care is in lieu of Medically Necessary Inpatient care.
Care given in an institution which operates as a hospice; and is licensed by the state or country in which it operates; and operates primarily for the reception, care and palliative control of pain for terminally ill persons who have, as certified by a Physician, a life expectancy of not more than six (6) months.
If you are hospitalized while traveling, and the hospitalization is considered a Covered Expense, the program will pay fixed amount (such as $100 or $50) for each night spent in the hospital, and this benefit is in addition to any other covered expenses in the insurance policy.
This coverage may vary based on the country of hospitalization and the individual plan chosen.
Cost of room and board in the hospital while receiving treatment as in-patient. In most plans, this benefit applies for average semi-private room expenses. This includes other miscellaneous expenses as well such as inpatient drugs, bandages, x-rays or other tests.
Cost of room and board in the hospital while receiving treatment as in-patient. In most plans, this benefit applies for average semi-private room expenses. In scheduled benefit plans, plan pays a daily set maximum limit for hospital room and board including miscellaneous services such as bandages and other supplies.
The Insurer will also pay up to specified amount in additional expenses per room for one night's lodging for each room guaranteed or confirmed through the Insured's Travel Agent that is oversold if the Insured's hotel is unable to provide reasonable, alternative accommodations.
Assistance service provided when your identity has been compromised while traveling on your vacation.
An insurance policy (life, health, or disability) that provides coverage for an individual person (and, in some cases, his/her immediate family members), as opposed to a group policy that provides coverage for a group of individuals such as coverage through an employer.
Braces and appliances: 1) when prescribed by a Physician; and 2) a written prescription accompanies the claim when submitted. Replacement braces and appliances are not covered. Braces and appliances include durable, medical equipment which is equipment that: 1) is primarily and customarily used to serve a medical purpose; 2) can withstand repeated use; and 3) generally is not useful to a person in absence of injury or sickness. No benefits will be paid for rental charges in excess of purchase price.
Cost of lab tests and x-rays when you are hospitalized (inpatient).
Person that purchases the insurance policy or enrolls into the insurance plan.
A Cardiac Care Unit or other unit or area of a Hospital that meets the required standards of the Joint Commission on Accreditation of Healthcare Organizations for Special Care Units.
Coverage for lab test (blood, test, urine test etc.) and x-rays, whether taken at doctor′s office and sent in for testing or preformed at a free standing laboratory(such as LabCorp or Quest).
Maximum amount of eligible medical expenses that the insurance company will pay during the entire term of the insurance policy.
Relay of e-mail or phone message to family, friends, or business associates.
24-hour hotline to make emergency travel changes, such as rebooking flights, hotel reservations, tracking lost luggage and more!
Cost of local ambulance to transport the insured to the nearest medical facility where adequate care can be given.
Some policies do not cover ambulance expenses if the insured is not immediately hospitalized after using the ambulance. Please read the brochure and policy for complete information.
This benefit will be paid in the event that the common carrier permanently looses an insured person's checked luggage. This coverage is secondary to any other available coverage, including the carrier's.
Magnetic therapy involves the use of a magnetic device placed on or near the body to relieve pain and facilitate healing. Many different types of magnetic products are available in the market today that can be taped to the skin, worn as jewelry or in your shoes, or slept on as pillows and mattresses. Many people try this in arthritis, insomnia, carpal tunnel syndrome, and fractures. It is believed that it has a profound effect on the body in relieving pain.
Theory is that magnetic fields produced by magnets (or by devices that generate electromagnetic current) can penetrate the human body and affect the functioning of individual cells and improve the working of the nervous system and various organs.
The manipulation of muscle and connective tissue to enhance the function of those tissues and promote relaxation and well-being. Therapeutic massage can ease tension and reduce pain. Massage can be a part of physical therapy or practiced on its own. It can also be highly effective for reducing the symptoms of arthritis, back pain, carpal tunnel syndrome, and other disorders of the muscles and/or nervous system.
Coverage for medical expenses for pregnancy such as routine check ups, sonogram, baby delivery and post-natal care.
Nervous and mental treatment is the care of patients with acute, treatable, and reversible psychiatric illness or with acute exacerbation of a chronic psychiatric condition.
A special radiology technique designed to image internal structures of the body using magnetism, radio waves, and a computer to produce the images of body structures. In magnetic resonance imaging (MRI), the scanner is a tube surrounded by a giant circular magnet. The patient is placed on a moveable bed that is inserted into the magnet. The magnet creates a strong magnetic field that aligns the protons of hydrogen atoms, which are then exposed to a beam of radio waves. This spins the various protons of the body, and they produce a faint signal that is detected by the receiver portion of the MRI scanner. A computer processes the receiver information, and an image is produced. The image and resolution is quite detailed and can detect tiny changes of structures within the body, particularly in the soft tissue, brain and spinal cord, abdomen and joints.
An MRI is painless and has the advantage of avoiding x-ray radiation exposure. There are no known risks of an MRI. The benefits of an MRI relate to its precise accuracy in detecting structural abnormalities of the body. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet. Metallic chips, materials, surgical clips, or foreign material (artificial joints, metallic bone plates, or prosthetic devices, etc.) can significantly distort the images obtained by the MRI scanner. Similarly, patients with artificial heart valves, metallic ear implants, bullet fragments, and chemotherapy or insulin pumps should also not have an MRI. Claustrophobia can be a problem. For an MRI, patients lie in a closed area inside the magnetic tube. Some patients experience a feeling of claustrophobia.
In the event of natural disaster (hurricane, flood, tornado, tsunami, etc), insurance plan will cover up to a certain amount per day and up to certain number of days if you are displaced from your planned, paid accommodations due to evacuation from forecasted disaster or following a disaster strike. Displaced is defined as required to depart your destination due to an evacuation ordered by prevailing authorities. Proof of paid accommodations must be submitted at time of claim.
Coverage for treatment of new born baby.
Maximum amount of money to be paid out of pocket in terms of co-insurance. e.g., if the co-insurance is 80/20 for first $5,000, out of pocket maximum is $1,000 (20% of $5,000).
Out of pocket maximum does not include deductible, as it is in addition to the deductible.
Once out of pocket maximum is paid, plan pays 100% up to the policy maximum for eligible medical expenses.
Any lab test that is done on an outpatient basis, i.e., when you are not hospitalized.
Surgery that is performed without getting admitted into the hospital. You get surgery done, rest for a while and go home, without actually staying in the hospital overnight.
Surgical treatment would be medical treatment from a physician or surgeon, or in a hospital as it relates to surgical care.
Outpatient surgical facility is used in connection with outpatient day surgery; excluding non-scheduled surgery, and a surgery performed in a hospital emergency room, trauma center, physician's office, or clinic. Benefits will be paid for services and supplies such as: the cost of operating room, laboratory tests and x-ray examinations including professional fees, anesthesia, drugs or medicines, therapeutic services and supplies.
Any treatment received while NOT admitted into the hospital. It could be doctors office visits, outpatient surgery or many other things.
Any x-ray that is taken on an outpatient basis, i.e., when you are not hospitalized.
The Insurer will pay the Insured up to $25 per day up to a maximum of $200 in total for any one claim to cover additional boarding fees incurred after the first 24 hours of the Insured's delayed return from his/her trip due to in-patient treatment overseas and as a result the Insured's pet exceeding a pre-booked period of accommodation within a recognized Boarding Kennel, Cattery, or Animal Shelter. The Insurer will not pay for the following in addition to the General Exclusions: 1) Claims which are not substantiated by a written report from the Boarding Kennel, Cattery, or Animal Shelter. 2) Any fees incurred in the first 24 hours or which did not form part of the original pre-booked duration for the Insured's pet.
Pharmacy Drug Discount Plan provides value added benefit. It is accepted at many chain pharmacies. It allows members to purchase prescriptions at the lowest cost available. It has no pre-existing conditions exclusion clause.
The plan does not guarantee that the prescribed medication is covered under the benefit plan, claims must be submitted for claim determination.
Treatment of injury and disease by mechanical means, as heat, light, exercise, and massage.
Visit to a physician's office can take place in a private practice, urgent care, or in a hospital. For example, if the physician is physically located in the hospital and is working independently, the visit will be considered an office visit and not part of a hospital visit.
Personal Liability is a benefit that provides coverage to a third person in case of accidental injury and/or death, loss or damage to material property if the insured person is legally liable for the accidental injury and/or death, loss or damage. This benefit may be included in a plan or it is an optional coverage (called a rider) that needs to be added when purchasing a plan.
Please refer to the plan documents for complete details.
Duration of policy for which the purchase can be done. Some policies can be purchased only in the multiples of months, while some policies can be purchased in multiples of 15 days. There are also some policies which can be purchased in multiples of days, with a minimum policy duration such as 5, 10 or 15 days.
Maximum amount of money that the insurance company will pay for covered expenses. Policy maximum can be either per policy period, per year, lifetime or per injury/sickness depending upon the insurance policy you purchase.
When a range of policy maximum is displayed in the quoting engine, it is simply for the purpose of quoting various insurance plans that have policy maximums that fall within that range. Policy maximum range is used to filter out the plans that do not fall within the range you are looking for and to be able to compare various insurance plans that fall within that range. It does not mean that all the displayed plans provide the highest amount of coverage mentioned in the policy range. It also does not mean that you will find a policy maximum that exactly matches the policy maximum that you may have in mind.
E.g., if you choose a policy maximum range from $200,000 to $300,000, the quoting engine will show various plans within that range, such as $200,000, $250,000, $300,000 or whatever other policy maximums are available. And such policy maximum amounts are mentioned next to each product when you see the quotes and therefore, you will know the exact policy maximum you are getting quoted for. All policies in that range do NOT provide coverage for $300,000. Also, available policy maximum amounts are set by each insurance company. Therefore, if you wanted a policy maximum of $231,462, for example, no such plan is available.
Pre-admission tests would be tests ordered by a physician prior to and related to the admission of the insured to a hospital confinement. e.g., complete blood count, urinalysis, chest x-ray. If otherwise payable under the policy, major diagnostic procedures such as, CT Scan, NMR's and blood chemistries will be paid under the "Hospital Miscellaneous" benefit.
Each proposed hospital admission and inpatient or outpatient surgery must be Precertified for medical necessity, which means the insured person or their attending physician must call the number listed on the insurance identification card prior to admittance to a hospital or performance of a surgery. In case of an Emergency Admission, the Precertification call must be made within 48 hours of the admissions, or as soon as reasonably possible. If a hospital admission or a surgery is not Precertified, eligible claims and expenses would be reduced by certain percentages such as 20%, 50% that varies by insurance plan. Precertification is not an assurance of coverage, a verification of benefits, or a guarantee of payment. All medical expenses must meet usual, reasonable, customary, and eligible payment guidelines.
A pre-existing condition is defined as any injury, illness, sickness, disease, or other physical, medical, mental or nervous condition, disorder or ailment that existed at the time of application or during the past duration (specified by each insurance plan) prior to the effective date of the insurance, including any subsequent, chronic or recurring complications or consequences related thereto or arising there from.
Chronic diseases such as diabetes, heart disease or blood pressure are always considered to be existing currently and they are never covered if you have previous history of those diseases, no matter what the pre-existing condition exclusion period written in any policy.
Some plans provide very limited coverage for sudden and acute re-occurance of pre-existing conditions.
Amount you pay to purchase medical insurance plan. Premium may be paid monthly, quarterly, semi-annually, annually or for entire duration of the coverage depending upon the insurance policy you purchase.
Any medicine that the physician prescribes and not available without prescription. It does not include over the counter medicines such as Tylenol, Aleeve etc.
Health care to keep you healthy or to prevent illness. For example, Pap tests, pelvic exams, yearly mammograms, immunizations, and flu shots.
A physician or other medical professional who serves as a group member's first contact with a plan's healthcare system. Also known as a primary care physician, personal care physician, or personal care provider.
A nurse who is not a member of a hospital staff but is called upon to take special care of an individual patient.
These services are meant only for private duty nursing care, while hospital confined, ordered by a licensed physician and a medical necessity. General nursing care provided by the hospital is not included under this benefit.
Any doctor visits from the women's personal doctor while in the hospital.
An artificial substitute for a missing part of the body of humans or other animals is called a prosthetic device, or prosthesis. Prosthetic devices include artificial hands, limbs, eyes, ears, as well as replacement materials for the heart, kidneys, skin, and blood.
A psychiatrist is a physician who specializes in the diagnosis, treatment, and prevention of mental illnesses and substance abuse disorders. It takes many years of education and training to become a psychiatrist: He or she must graduate from college and then medical school, and go on to complete four years of residency training in the field of psychiatry. (Many psychiatrists undergo additional training so that they can further specialize in such areas as child and adolescent psychiatry, geriatric psychiatry, forensic psychiatry, psychopharmacology, and/or psychoanalysis.) This extensive medical training enables the psychiatrist to understand the body's functions and the complex relationship between emotional illness and other medical illnesses. The psychiatrist is thus the mental health professional and physician best qualified to distinguish between physical and psychological causes of both mental and physical distress.
The use of high-energy rays to damage cancer cells, stopping them from growing and dividing. Like surgery, radiation therapy is a local treatment that affects cancer cells only in the treated area.
Radiation can come from a machine (external radiation or from an a small container of radioactive material implanted directly into or near the tumor (internal radiation). Some patients receive both kinds of radiation therapy. External radiation therapy is usually given on an outpatient basis in a hospital or clinic, five days a week for several weeks. Patients are not radioactive during or after the treatment. For internal radiation therapy, the patient stays in the hospital for a few days. The implant may be temporary or permanent. Because the level of radiation is highest during the hospital stay, patients may not be able to have visitors, or may have visitors only for a short time. Once an implant is removed, there is no radioactivity in the body. The amount of radiation in a permanent implant goes down to a safe level before the patient leaves the hospital.
Side effects of radiation therapy depend on the treatment dose and the part of the body that is treated. The most common side effects are tiredness, skin reactions (such as a rash or redness) in the treated area, and loss of appetite. Radiation therapy can cause inflammation of tissues and organs in and around the body site radiated. Radiation therapy can also cause a decrease in the number of white blood cells. Although the side effects of radiation therapy can be unpleasant, they can usually be treated or controlled. It also helps to know that, in most cases, they are not permanent.
If some insurance policies are purchased for at least certain duration at a time, they are renewable. Please note that this is renewal of policy and NOT a new policy. That means that if something happens in the previous policy period, it will not be considered as a pre-existing condition. While if you take a new policy, it will be considered as a pre-existing condition. Thus renewability is a big advantage. If you purchase a new policy, new deductible, co-insurance etc. may apply again and that varies by each policy. Please refer to the brochure for specific details.
There are some policies which are renewable for certain duration at a time if purchased online and renewable for a larger duration at a time for paper applications. (e.g., Inbound USA is renewable every 5 days if purchased online while it is renewable every 3 months if paper application is made.)
Insurance company (or administrator) may charge administrative fees such as $5 or $10 every time the policy is renewed. And if you forget to renew it even once, even by one day, the policy will expire and you will have to make a new purchase. In other words, it is not automatic renewal. You have to explicitly renew it every time.
If a covered illness/injury results in a death, expenses for repatriation of bodily remains or ashes to the country of residence.
If an insured person is hospitalized due to a covered illness/injury and is traveling alone with child(ren) of age 19 or under that otherwise would be left unattended, the cost of one way economy fare to their home country, usually up to some reasonable maximum amount.
Covered expenses incurred as a result of a Sickness which manifests itself during the Covered Trip.
An office to the physician who specializes in a certain medical field. e.g. Oncologist specializes in the field of cancer, ophthalmologist specializes in the field of eye, dermatologist specializes in the field of skin.
Injuries while playing amateur sports.
Substance abuse is overindulgence in and dependence on a psychoactive leading to effects that are detrimental to the individual's physical health or mental health, or the welfare of others.
Substance abuse is sometimes used as a synonym for drug abuse, drug addiction, and chemical dependency, but actually refers to the use of substances in a manner outside sociocultural conventions.
Supplemental accident coverage plans cover accidental injuries. As it is not subject to deductible and coinsurance, it provides first dollar coverage. This can be especially very useful for someone with small kids who end up getting minor injuries and need medical care.
Please note that irrespective of whether supplemental accident coverage is offered or not, you are still covered for accidents. This supplemental accident is just additional coverage with no deductible or coinsurance.
An invasive diagnostic or surgical procedure; or the treatment of illness or injury by manual or instrumental operations performed by a physician while the patient is under general or local anesthesia.
Surgical treatment would be medical treatment from a physician or surgeon, or in a hospital as it relates to surgical care.
A consultation from a surgeon prior to surgery. For example, an insured is in the emergency room, having extreme abdominal pain. A surgeon would then be consulted, and he would decided whether or not a surgery needs to be performed.
Term life is an insurance in which if you die during the term of the insurance while insurance is effective, your beneficiary gets the death benefit. If you don't die during the term, there is no refund or any money back to you at the end of the term.
The willful termination of a pregnancy determined to be medically necessary for the wellbeing of the mother.
The grafting of a tissue from one place to another. The transplanting of tissue can be from one part of the patient to another (autologous transplantation), as in the case of a skin graft using the patient's own skin; or from one patient to another (allogenic transplantation), as in the case of transplanting a donor kidney into a recipient.
Common examples are kidney transplant, heart transplant, lung transplant, liver transplant etc.
Insurer will reimburse incurred expenses up to a daily limit, and up to the maximum limit shown on schedule of benefits if the insured's trip is delayed for more than certain hours for reasonable additional expenses until travel becomes possible. Incurred expenses must be accompanied by receipts. Travel delay must be caused by reasons listed under trip cancellation and interruption, in addition to generally: (a) carrier delay; (b) lost or stolen passport, travel documents, or money; (c) quarantine; (d) Natural Disaster; or (e) Injury or Sickness of the Insured or Traveling Companion. The insured must contact the insurance company as soon as the insured knows his/her trip is going to be delayed more than hours specified in the schedule of benefits. Failure to do so may affect coverage.
Replacement of lost travel documents such as passport.
The insurer will pay this benefit up to the maximum limit shown on the schedule of benefits if a trip is delayed, cancelled, or interrupted due to any of the unforeseen covered reasons.
Common reasons include sickness, injury, or death of an insured or immediate family member, termination of employment, insured's principal residence or destination being made uninhabitable by fire, flood, vandalism, etc, military duty, etc. Please check the plan brochure for listing of all reasons as they differ in various plans.
If, during a covered trip, there is a death of an immediate family member (spouse, child, parent or sibling) or the substantial destruction of the insured's principal residence, many plans would pay for the insured to return to the area of principal residence. Many plans usually pay for one way air or ground transportation ticket of the same class as the unused travel ticket, less the value of the unused return ticket.
Urgent care is treatment for an illness or injury that does not pose an immediate, serious health threat or would not result in further disability or death if not treated immediately, but require prompt attention and have the potential to develop such a threat if treatment is delayed longer than 24 hours. In other words, urgent care is the delivery of ambulatory care in a facility dedicated to the delivery of unscheduled, walk-in care outside of a hospital emergency department.
e.g., ear infections, sore throat, sprained ankles, rising temperature are examples of conditions that urgent care staff can treat.
Unintentional damaging event involving automobiles.
The use of vitamins to prevent or cure disease. Many physicians are now recognizing the beneficial uses of anti-oxidant and other vitamins for a wide variety of conditions, often as a complementary therapy to accompany medication or other treatments. One variant on this theme, megavitamin therapy, is still rather controversial. Always consult your doctor before adding vitamin supplements to your health regimen.
Disclaimer: The information within this article is intended as a broad summary of benefits and services and is meant for informational purposes only. The information does not describe all scenarios, coverages or exclusions of any insurance plan. The benefits and services of an insurance plan are subject to change. This is not your policy/certificate of insurance. If there is any discrepancy between the information in this article and the language of your policy/certificate wording, the language of the policy/certificate wording will prevail.