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Health Insurance Dictionary
Understanding health insurance jargon is very important to ensure you know what you are purchasing and what is covered before you buy.
- What is a High-cost Provider – Each insurer has a list of hospitals which are deemed as ‘luxury’ or ‘high-cost’ due to the high cost of treatment. These include but are not limited to United Family Hospital and Parkway Health in China and a number of hospitals in HK & Singapore. Each insurer has a different high-cost provider list.
- Private Hospitals – These are medical facilities with a higher quality of service and English speaking doctors.Coinsurance – is the percentage your insurance will pay to cover your healthcare costs after any deductibles and co-pays have been met. Once you have reached your annual deductible (see above for definition) your insurer will pay a percentage of any healthcare costs after this, usually 70-80%. You will be required to pay the remaining 20-30% as coinsurance.
- What is Copayment (copay) – is a small fixed amount, determined by the health insurer, that the insured person must pay every time a medical service is accessed. The fixed sum depends on which medical service is used.
- What is Deductible – is the amount of money the insured person pays each year in order for the health insurance company to reimburse them for the covered health care expenses.
- What is Inpatient Care – is the health care that the insured person will receive if they stay overnight in hospital.
- What is Lifetime Maximum – is the maximum amount that an insurance company will pay throughout your lifetime.
- What is IPMI – Individual Private Medical Insurance
- What are Pre-existing conditions – is any known health condition or illness that the policyholder must declare before signing the health insurance contract. You need to be aware that by not declaring particular pre-existing conditions is likely to result in invalid insurance. Pre-exisiting conditions include diabetes, high blood pressure, pregnancy*, and they may or may not be covered by your plan. *You should discuss with your insurer whether your plan is flexible in terms of pregnancy, if this is part of your future plan, as there may be more options available to you that you might not be aware of.
- What are Premiums – is the actual cost of your insurance plan, i.e. the amount you or your employer must pay per month for you health insurance. The higher your premium the higher your coverage, and therefore you will pay less for medical bills.
- Reasonable and customary fee – this is what your insurance provider says is the average payment for a medical procedure or service. It depends on your geographic area, if you pay more than this fee you may not be able to claim all the costs back. Expats can ask their insurer for quotes for average medical procedures depending on where they are moving to.
- What is Underwriting – the process by which insurers decide whether an individual is eligible for health insurance and how much they should pay.