GlossaryHealth InsuranceI to L
You will find an expanded list and definition of terms in this glossary health insurance I to L section.
Use it often, especially when you begin to review your health insurance policy and benefits.
I
indemnity insurance: Health insurance allows you to use any medical
provider that you choose. As such,
there are no networks to utilize. The insurance company pays you predetermined
benefits for covered services. Also known as “fee-for-service” and comprehensive
plans.
indemnity: Benefit paid by an insurance policy for an insured loss.
intermediary: The insurance company of the Department of Health and Human
Services responsible for paying patients and health care providers.
individual practice association (IPA): A type of open-panel HMO that
contracts with an association
of physicians who agree to provide services for HMO members.
inpatient surgery: Medical procedures that require you to spend at least one night at the hospital.
Most plans set the amount of time you may stay at the hospital following
surgery.
insurance agent: A person authorized by an insurance company to represent
the company in its dealings with applicants for insurance.
insurance: Risk management plan that, for a price, assumes some or all of
your risk of serious financial loss if a covered event occurs.
independent medical review: A process where expert medical professionals
who have no relationship to your health insurance company or health plan review specific medical decisions made by the insurance company.
J
Joint Commission on Accreditation of Health care Organizations (JCAHO): A
non-profit organization that evaluates and accredits health care organizations based the quality and safety of care provided.
K
Kassebaum-Kennedy: See HIPAA.
L
lapse: Termination of your insurance coverage when you fail to pay the
premium.
late enrollment: Enrollment in a healthcare plan during a time other
than the regular or a special
enrollment period. If you are a late enrollee, you might be subjected to a
longer pre-existing condition
exclusion period.
life dependent: An option offered by some plans that provides a set
amount of life insurance for your dependents.
lifetime aggregate or maximum: The maximum amount of money your insurance
will pay towards your healthcare services. Health insurance policies often carry
a $1 million to $2 million lifetime aggregate.
limited health insurance: Policies that cover specific injuries and
illnesses.
list billing: The practice of an employer enabling his/her employees to
purchase individual insurance
coverage and paying for it themselves by withholding payroll. The employer
simply acts as a conduit for
those premium payments.
long-term care: Care for patients with chronic diseases or disabilities
including home health care, adult
day care, hospice care, respite care, and intermediate care but not hospital
care.
look back: The maximum amount of time (immediately prior to signing up
for a health plan) that you can
be examined for any type of evidence of preexisting conditions.
loss ratio: The ratio of claims to premiums (claims divided by premiums).
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