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 optionally renewable health insurance contracts, where the insurer reserves the right to terminate the policy at specific intervals such as the policy anniversary or premium due date.
Learn about switch maternity provisions in health insurance where female employees are covered only if their husbands are listed as dependents. Understand key aspects of this policy.
Learn about the calendar year deductible in health insurance—how it works and its importance no matter how many claims are made within a calendar year.
Explore the concept of Coordination of Benefits in health and life insurance. Learn how it determines the primary insurer when you're covered by multiple insurers.
Learn about duplicate coverage inquiry in health insurance, including its purpose in coordinating benefit stipulations when multiple insurers are involved.
Explore the concept of Medical Loss Ratio in Health Insurance, which is calculated as total benefits divided by total premium. Learn its significance in the health insurance industry.
Learn about paid business in health and life insurance, including the application process, premium payments, and medical exams required.
Learn about the elimination period in health insurance policies, an important waiting or probation period that affects when benefits begin.
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.
Learn about Disability Insurance, a vital policy that offers financial protection by paying out benefits when the insured is unable to earn an income due to disability. Understand the coverage for total, catastrophic, or residual disabilities.
Learn everything about guaranteed renewable contracts in health and life insurance. Understand how these policies work, the benefits, and what to consider when opting for such contracts.
Discover what a health plan (health insurance) entails, including details on medical service coverage for members. Learn how these plans ensure access to essential healthcare.
Learn about a Home Health Agency, an essential component in health insurance, approved by and contracted to a health plan to provide certain services.
Learn about home health services covered by Medicare Part A, including care provided by licensed agents. Understand the scope of home health care services under Medicare.
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.
Explore Multi-disciplinary Health Insurance and understand how this treatment approach involving multiple specialists from different disciplines ensures comprehensive healthcare coverage.
Learn about outcomes measurement in health insurance, a crucial method for assessing treatment provided to patients and their responses to each intervention.
Learn what a Superbill is in health insurance. It lists every service provided by a doctor, aiding in accurate billing and claims.
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.
Explore the concept of 24-hour care coverage which combines work-related and non-work-related benefits to offer continuous protection for illnesses and injuries.
Learn about the role of a family dependent in health insurance, including coverage for spouses and single dependent children residing with the insured policyholder.
Discover how hospital alliances work in health insurance, enabling multiple hospitals to share services and reduce costs, helping them stay competitive in the healthcare market.
Explore the definition of limited health insurance, a type of health insurance policy that specifically covers certain illnesses or injuries as outlined in the contract. Learn about its features and coverage limits.
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.
Explore the concept of underinsurance in the context of property and health insurance, its implications, and strategies to prevent insufficient coverage.
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 the customary charge, the average cost of medical procedures used to determine Medicare benefits, and its impact on health insurance.
Explore the concept of discharge planning in health insurance, a critical process that involves creating a tailored treatment plan for patients after their release from inpatient care. Discover its importance and impact on patient outcomes.
Learn about dismemberment in health insurance, the loss of specific body parts or their use due to accidental injury and its impact on coverage.
Discover how double indemnity in health and life insurance works. Learn when twice the policy value is paid out in cases of accidental death or specific situations.
Learn about the Dual Choice in Health Insurance, a federal regulation requiring certain employers to offer both an indemnity plan and an HMO. Applicable to employers with 25+ employees, paying minimum wage or more, offering health care coverage, and a federally certified HMO available in the area.
Learn about the term 'Eligible Employee' in health insurance, who qualifies, and the available group policy benefits. Understand what makes an employee eligible for health insurance benefits.
Learn about Exclusive Provider Organization (EPO) health insurance plans. Discover how EPOs operate with primary care doctors and provider referrals.
Learn about Extension of Benefits in Health Insurance, a critical policy condition that offers extended coverage for non-working employees or hospitalized dependents.
Learn about Federal Qualification by the Health Care Financing Administration and its importance for HMOs in ensuring quality health services.
Learn about the term 'Field' in general insurance. Discover how it categorizes insurance types like health insurance and refers to regions served by agents.
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 free standing emergency medical service centers, also known as urgent care centers, and their importance in providing emergency medical attention in the health insurance landscape.
Discover the essentials of group health insurance, including hospital stays, medical examinations, treatments, and doctors' fees. Learn about mandatory deductibles and coinsurance payments.
Learn about Guaranteed Standard Issue in health insurance, a group plan that ensures coverage for all policyholders regardless of their medical history.
Learn about the Health Care Financing Administration, a division in the Department of Health and Human Services that oversees Medicare and Medicaid and sets certification guidelines for medical care providers.
Learn about the Health Insurance Association of America (HIAA), a group that promotes health insurance through generating publicity, research, and education. Backed by insurers, HIAA works towards enhancing the understanding and accessibility of health insurance.
Discover the definition of a health insurance enrollee and why they do not include dependents. Learn what it means to be an enrollee in a health insurance context.
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.
Learn about Key Employee Insurance and its significance in health and life insurance, ensuring continuity and financial protection for businesses against the loss of key personnel.
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.
Explore Long Term Care Insurance and how it provides daily benefits when insured individuals become residents in nursing homes. Ensure your healthcare financial security by understanding this crucial aspect of health insurance.
Explore the definition, scope, and legal requirements of mandated benefits in health insurance, including both state and federal regulations.
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.
Learn about the Market Assistance Plan (MAP) promoted by the Department of Insurance, designed to help buyers secure difficult-to-find health insurance. Understand its role, benefits, and how it aids in obtaining the necessary 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 the Omnibus Budget Reconciliation Act (OBRA) and its impact on health insurance, specifically in extending COBRA continuation coverage for disabled individuals from 18 to 29 months.
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.
Learn about out-of-pocket costs in health insurance, including deductibles and prescription medication expenses. Discover how they impact your healthcare expenses.
Learn the role and importance of a Participating Provider in Health Insurance, including their approval process in Medicare and how they are compensated.
Understand the role of peer review in health insurance, a process where medical treatments are evaluated by equally trained medical professionals to ensure quality and adherence to standards.
Learn about Permanent Partial Disability, a condition where the insured is impaired but not totally incapacitated, enabling them to work in some capacity. Essential for understanding Health Insurance and Workers Compensation.
Discover the significance of Physician’s Current Procedural Terminology (CPT) in health insurance. Learn how the AMA's manual standardizes the documentation of medical procedures and services.
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 the prospective reserve in health and life insurance, a reserve that accounts for future premiums, interest, and is sufficient to pay future claims.
Learn about Railroad Travel Policies in health insurance, a unique form of travel accident insurance typically sold at railroad stations.
Explore the crucial role of a Registered Nurse (Health Insurance) in providing nursing care, including medication distribution, and their importance in the healthcare system.
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.
Learn about Retrospective Rate Derivation in Health Insurance, where employers pay a fraction of health care costs and may receive refunds based on actual expenses.
Explore the intricacies of risk analysis in health insurance, where benefits and premiums are tailored to fit specific groups based on comprehensive analysis.
Understand the concept of single carrier replacement in health insurance, where one insurance carrier replaces multiple carriers to simplify your coverage.
Learn about Social Health Maintenance Organizations (SHMOs), a Health and Human Services funded project combining adult day care, transcription, acute, and long-term care services.
Learn about step-rate premiums in health and life insurance, including how they increase at predetermined times and their connection with policy terms.
Explore the essential aspects of stop-loss insurance, a type of reinsurance for health plans or employer-funded plans, designed to safeguard against substantial financial losses.
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.
Explore Thaisoi, an ancient Greek institution that laid the foundations for modern health insurance and life insurance. Delve into its historical impact and influence on today's insurance frameworks.
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.
Explore the flexibility of cafeteria benefit plans in health insurance which allow employees to customize their premiums and benefits.
Learn about conditional receipts in life and health insurance, how they serve as proof of an interim contract, and the conditions under which an insurance company must pay out benefits.
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.
