Learn about the role of a practical nurse in health insurance, focusing on their duties like assisting patients with daily tasks and the limitations such as not being able to dispense medicine.
Learn about large claim pooling in health insurance, a system that helps stabilize premium amounts for smaller groups by pooling larger claims together.
Learn about the National Association of Health Underwriters (NAHU), an organization supporting professionals who service health care needs, including brokers, agents, and consultants.
Learn about surgical insurance benefits, a health insurance coverage option that helps cover the costs of losses due to surgical expenses.
Understand blanket coverage in health insurance. Learn how it differs from individual and group plans, providing comprehensive coverage for various risks under one plan.
Explore the benefits of Group Disability Insurance, a group policy designed to provide income coverage during periods of disability or illness.
Learn about Health Maintenance Organization (HMO) health insurance plans, how they work, and the obligations for employers with more than 25 employees.
Explore the concept of conversion in life insurance, health insurance, and general insurance. Understand the transfer processes and legal implications.
Learn about Inside Limits in health insurance and how they apply to hospital expense benefits. Understand their significance compared to maximums stated in the policy contract.
A comprehensive guide to what qualifies as sickness in health insurance policies, excluding mental illness.
Understand what a confining condition in health insurance entails. Learn how illnesses or disabilities that force confinement at home or a medical facility affect your coverage.
Learn about covered expenses in health insurance, including what qualifies for reimbursement or coverage under your policy. Understand the essentials for managing your healthcare costs effectively.
Understand the concept of an exception in health insurance policies. Learn about clauses in policy contracts that void or remove the obligation for coverage, and how these can impact your health insurance benefits.
Learn about the gender rule in health insurance, which determines which parent's policy will primarily cover dependent children. Find out how the father's policy is prioritized for claims under this rule.
Learn what an 'Outpatient' means in the context of health insurance, including how they receive treatment without staying overnight in a hospital.
Learn about the Ten Day Free Look period in health insurance, a consumer right that allows you to fully inspect your policy and return it within ten days for a full refund.
Explore the definition of disability in general insurance terms, focusing on medical conditions or psychological afflictions that limit daily activities. Learn about temporary and permanent circumstances.
Learn about supplemental services in health insurance, the extra services you can add to basic coverage to enhance your health plan benefits.
A comprehensive guide to surgical schedules in health insurance, detailing the list of surgeries and the associated benefits.
Learn about the waiting period in health insurance, also known as the elimination period. It is the time between the start of a disability and when benefits begin.
Learn about expected claims in health insurance, the anticipated amount of claims during a contract year, and how they are determined by statistical data.
Discover how franchise insurance, also known as wholesale insurance, provides group health insurance coverage for small groups, offering individual contracts and underwriting.
An individual contract in health insurance is a policy that covers a particular individual and may extend to include other family members. Learn the essentials of individual health insurance contracts, including their benefits and coverage details.
Understand miscellaneous expenses in health insurance, covering additional charges during a hospital stay like diagnostic test fees. Learn about reimbursement limits for these expenses.
Explore nonmedical policies in health and life insurance, where no medical examination is required. Understand the benefits and essentials of these insurance options.
Learn about 'Open Access' in health insurance, a concept that permits policyholders to visit specialists without referrals. Explore its benefits and implications.
Explore what a Social Security rider in health insurance entails and how it influences disability income policies by potentially providing extra benefits based on Social Security payouts.
Learn about the standard class rate in health insurance, a vital component in calculating group demographic information by applying a base rate for each participant.
Learn about aggregate indemnity in health insurance, the maximum amount that can be claimed under a policy. Understand its significance and limitations.
Learn about Preferred Provider Organization (PPO) networks in health insurance, how they operate, and their benefits compared to HMO plans. Discover the flexibility PPOs provide for choosing healthcare providers.
Explore the role of treatment facilities in health insurance, specifically focusing on centers that address substance abuse and mental illness.
Learn about Hospital Tax in Health Insurance, a mandatory social security tax that funds Medicare Part A costs. Discover its purpose and implications.
Learn about non-disabling injuries in health insurance, where lesser injuries may be eligible for small benefits compared to total or partial disabilities.
Explore the rating process in health insurance, which determines premium rates based on factors such as sex, age, benefits, and administrative costs.
Learn about permanent and total disability in health insurance, a designation for disabilities that persist beyond six months and are deemed incurable.
Explore Hospital Insurance under Part A of Medicare, including coverage for inpatient hospital stays, home health care provided by nurses, and hospice care. Learn about services requiring co-payments or deductibles.
Learn about the term 'Invalidity' in health insurance, which is often interchangeable with illness, and its implications for policyholders.
Learn about duplicate coverage inquiry in health insurance, including its purpose in coordinating benefit stipulations when multiple insurers are involved.
Discover the minimum benefits provided by a health insurance policy, also known as a basic hospital plan. Learn about the essential features of basic benefits in health insurance.
Understanding the inflation factor in health insurance: An addition to premiums to account for future inflation in medical costs and loss payments. Get insights on how this affects your health insurance premiums.
Learn about intentional injury within the context of health insurance, focusing on injuries caused by willful acts meant to cause harm and their coverage implications.
Understand the intoxicants and narcotics provision in health insurance policies, which excludes coverage for losses resulting from intoxication or unsupervised narcotic use.
Learn about outcomes measurement in health insurance, a crucial method for assessing treatment provided to patients and their responses to each intervention.
Learn about the Trial Work Period under Social Security, a method allowing injured or disabled workers to reenter the workforce without losing disability income benefits for up to nine months within a five-year period.
Learn about Acceleration Life Insurance, a policy feature that allows the insured to access a portion of the death benefit before death for certain medical costs.
Learn about the role of a family dependent in health insurance, including coverage for spouses and single dependent children residing with the insured policyholder.
Explore the concept of self-funded insurance plans, where employers directly pay eligible claims. Discover the advantages and considerations of this approach to manage steady and predictable healthcare and life insurance costs.
Explore what skilled nursing care entails in health insurance. Learn about daily care requirements, certified professional involvement, medication, and treatment of existing conditions.
Learn about the benefit period in health insurance, a crucial time frame during which policy benefits are paid out to the insured or their dependents.
Learn about the contract year in health insurance, which spans from the effective date to the expiration date. Discover how this period affects your coverage.
Learn about the cost of living benefit in health insurance, which ensures that disability benefits increase after 12 months and annually thereafter to keep up with inflation.
Learn about dismemberment in health insurance, the loss of specific body parts or their use due to accidental injury and its impact on coverage.
Learn about Federal Qualification by the Health Care Financing Administration and its importance for HMOs in ensuring quality health services.
Understand the flat maternity benefit in health insurance, a provision that covers all hospital costs associated with maternity care, regardless of the stay's cost.
Learn about home health care, a service provided at a patient's home by nurses, health care aides, or therapists. Discover how this part-time care option can benefit patients and their families.
Discover what a Line Slip is in health insurance. Learn how this broker-written document outlines prospective risks for underwriters and the fractions of risks they insure.
Learn about mandated providers in health insurance, which are healthcare providers whose services must be legally included in health plans. Understand the importance of these regulations for comprehensive health coverage.
Discover everything about the Maximum Allowable Cost List in health insurance, a critical component that bases prescription reimbursement on generic drug costs.
Learn about Medicaid, a state-administered healthcare program funded by the federal government, designed to assist individuals who meet specific income and eligibility requirements in covering medical expenses.
Learn about Medicare supplement insurance, an essential adjunct that helps cover deductibles and co-payments not covered by Medicare. Explore how it works, what it covers, and how to choose the right plan for you.
Learn about the Modified Fee for Service model in health insurance, where reimbursements for actual procedure costs are made up to a specific maximum. Understand its impact on healthcare payments.
Learn about Noncancellable Health Insurance policies where the insured can maintain coverage by paying premiums, with guaranteed terms and unchangeable premiums.
Understand nonconfining sickness in health insurance, an illness that does not force the insured to remain indoors. Learn its definition and implications.
Understand the concept of Nonparticipating Provider Indemnity Benefits in Health Insurance, where coverage is provided for services by nonparticipating medical providers.
Learn about out-of-area health insurance coverage, which refers to treatment provided outside the usual geographic coverage area. Get insights into how it works and what to expect.
Explore the concept of Prevailing Charge in Health Insurance, which refers to the standard charge for a service in the insured's geographical area and its role in determining Medicare benefits.
Discover the significance of preventive care in health insurance, including examples like yearly mammograms and regular checkups, aimed at preventing illnesses.
Understand the probationary period in health insurance, a timeframe during which the insured is not yet covered but the policy is considered effective.
Learn about residual disability in health insurance, an important concept that covers the lingering partial disability after an insured person returns to work following a total disability.
Understand the concept of single carrier replacement in health insurance, where one insurance carrier replaces multiple carriers to simplify your coverage.
Learn about supplemental medical insurance, a voluntary program that covers physician’s costs and outpatient care, and how it is structured under Medicare Part B.
Temporary disability benefits provide financial support for employees who qualify due to non-occupational disabilities. Learn about your rights and coverage according to health insurance regulations.
Learn about the time of payment of claims provision in health insurance, which mandates that claims be paid immediately or within a specified number of days.
Learn about travel accident insurance, a form of health insurance that covers losses due to accidents while traveling. Ensure your trips are safe and secure.
Learn about the trend factor in health insurance, a key element that accounts for increasing costs such as the inflation of doctor’s costs and healthcare services.
Understand Triple Option health insurance plans offered by employers, providing employees with various provider types that vary in costs and coverage.
Learn about true group insurance, a type of group insurance policy issued with a master contract and certificates of insurance for each member. Understand how it differs from individual policies.
Learn about Subscriber Contracts in Health Insurance, which detail the benefits available to each registered individual. Ensure you know the key aspects of your health care plan.
Learn about cost sharing in health insurance, a system wherein individuals pay a fraction of health care costs, such as co-payments, and how it impacts coverage.
Learn about detoxification, the physical withdrawal process from alcohol or drugs under medical supervision, as covered by health insurance.
Explore the essentials of disability benefits law, a legislation ensuring workers receive compensation for injuries outside the workplace. Enacted in states like California, New York, Hawaii, and Rhode Island.
Explore what duplication of benefits means in health insurance, where similar or indistinguishable coverage exists between two or more insurers, and how it impacts policyholders.
Learn about 'Eligible Dependent' in health insurance, a person who relies on the policyholder for financial support and is eligible for benefits. Explore the criteria and implications.
Learn about what an Explanation of Benefits (EOB) is, how it itemizes health services, the incurred costs, the payments made by your insurer, and your responsibilities.
Learn about the grace period in health and life insurance policies, including what it means for your coverage and payment schedules.
Learn about the Health Services Agreement, an arrangement detailing benefits, enrollment, and eligibility between employers and insurers in health insurance plans.
Learn about Loss of Income Insurance, a crucial form of health insurance that provides coverage in case of lost income. Discover how it protects you financially.
Learn about mental health providers in health insurance, including social workers, psychologists, and psychiatrists who meet federal and state requirements to offer mental health care.
Learn about mental/emotional distress in general insurance, a psychological condition that is typically covered when resulting from an accident.
Learn about nurse fees in health insurance policies, a clause that allows reimbursement for amounts paid to independent nurses. Discover how this impacts your healthcare costs.
Explore the concept of Offset Rider in health insurance, including how it reduces benefits by accounting for the insured’s social security benefits.
Learn what a Primary Care Network (PCN) is in health insurance, including the role of primary care doctors within a plan.
Learn about reasonable and customary charges in health insurance, what they mean for your healthcare costs, and how they relate to provider charges and Medicare-approved costs.
Learn about Short Term Disability Insurance, a type of policy that covers disabilities lasting from 13 to 26 weeks. Understand its benefits, coverage details, and how it fits within Health Insurance.
Learn about swap maternity in health insurance. Understand how pregnancy coverage works under a group health plan and what happens if the plan terminates.
Learn about the co-pay provision in health insurance, which defines the portion of a claim paid by the insurer and the insured.
Learn about the physical exam and autopsy clause commonly found in health insurance policies. Understand its implications and what it means for policyholders and their families.
Dive deep into the unpaid premium provision in health insurance, an important clause that permits unpaid premiums to be deducted from claim payments. Learn how this provision can impact policyholders and claims.
Learn about triage in health insurance, a critical system used to rank patients based on the severity of their injuries or illnesses, ensuring that those in urgent need receive prompt care.
Learn about Unemployment Compensation Disability Insurance, a health insurance option covering non-workplace accidents and sickness. Does not encompass injuries covered by workers' compensation.
