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Health Insurance

Common health insurance terms and what they mean

How well do you know your insurance terminology?

Having a good understanding of some of the most common terms can make it easier to get the most out of your policy, and to know what to expect when it comes time to claim.

Here are a few to note.

Premiums: Premiums are the payments you make on a regular basis. These keep your cover active and ensure that the policy is there when you need it. Depending on the type of premium you have, premiums can increase every year based on factors such as your age, as well as wider industry factors and inflation. If you’re not sure why your premiums have changed, we can help.

Excess: An excess is the amount that you are required to pay before your insurer takes over. If you have a $500 excess and your treatment costs $20,000, for example, you’ll be expected to pay $500 and the insurer will pick up $19,500, provided that is within the policy claim limit.

Claim: A claim is where you ask your insurer to cover or contribute to the cost of your healthcare. You might make a claim before you have the treatment, as a preapproval, or you might put in the claim to be reimbursed afterwards.

Policy: The policy is the contract between you and the insurer that lays out the terms at which cover is offered.

Pre-existing conditions: Pre-existing conditions are any health conditions – which could include symptoms or signs, without a formal diagnosis – that you had before you took out the policy. In some cases, there will not be cover for these.

Underwriting: This is the process that insurers go through to determine what risk you pose in terms of possible claims, and what cover can be offered to you at what price.

Exclusions: Exclusions are things that you won’t be able to claim for under your health insurance. Sometimes they will be general – meaning that no one could claim for that event– and in other cases they might be personal, which could be related to your medical history or any pre-existing conditions you have.

Yearly limit: Your insurance may come with a limit on how much can be claimed in a 12-month period.

Want to talk?

If you have questions about insurance, drop us a line. We can help you work out whether your insurance cover remains appropriate for you, or whether there might be a better fit in the market. As your needs change, it’s helpful to check regularly to make sure your insurance cover remains fit for purpose.

 

Disclaimer: Please note that the content provided in this article is intended as an overview and as general information only. While care is taken to ensure accuracy and reliability, the information provided is subject to continuous change and may not reflect current developments or address your situation. Before making any decisions based on the information provided in this article, please use your discretion and seek independent guidance.

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