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Basic Insurance Terms and Definitions
Basic Insurance Terms and Definitions

Benefits

A sum of money or services provided to the insured according to the terms of the contract.

Claim

A formal request by the insured for payment for a covered expense.

Co-payment

The amount for which the insured is responsible after the deductible (if applicable) has been met. For example, under an HMO medical plan you may be required to pay a fixed amount during each visit to your doctor.

Deductible

The amount of money that the insured individual is required to pay before the insurance company pays its own share of the expense. NOTE: Some policies will have a lower deductible if you visit your schools "Student Health Service".  Montgomery College does NOT have a health center.  Be prepared to pay the higher deductible and ask the company if you can get a 'waiver' for the lower amount.

Emergency

Hospital service usually reserved for serious or urgent care situations. Most HMOs require a referral from your primary care physician.

Exclusions

Expenses or services that are not covered under the terms of an insurance policy and must be paid by the insured.

Lapse in Coverage

Termination of policy normally due to nonpayment of premiums.

Policy

A contract issued by the insurer stating the benefits, limitations, and exclusions of an insurance plan.

Pre-existing condition

A medical condition that existed before the plan was purchased. The company does not normally cover expenses related to this condition.

Premium

Payment made periodically (monthly, quarterly or semi-annually) to the insurer to ensure coverage.

Glossary of Health Coverage and Medical Terms. 


Montgomery College

Montgomery County, MD

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