It is insurance against loss through sickness or accidental bodily injury.
A PPO is a preferred provider organization. It is an association of health care providers such as doctors and hospitals that agree to provide health care to members of a particular group at negotiated fees in advanced. In most PPOs you do not select a primary care physician at the time of joining a health care plan. Also the majority of PPOs do not require the member to acquire a referral from the primary care physician to set up an appointment with a specialist.
A HMO is a health care management organization. HMOs stress preventive health care, early diagnosis and treatment on an outpatient basis. Persons generally enroll voluntarily by paying a fixed fee periodically. In most HMOs you select a primary care physician at the time of joining a health care plan. Also the majority of HMOs require the member to acquire a referral form the primary care physician to set up an appointment with a specialist.
A group insurance is insurance that provides coverage for a group of persons, usually employees of a company, under one master contract.
A coinsurance is the principle under which the company insures only part of the potential loss, the policy owner paying the other part. In a major medical policy, the company may agree to pay 80% of the insured expenses, with the insured to pay the other 20%.
A deductable is an amount of expense or loss to be paid by the insured before a health insurance policy starts paying benefits.
A co-payment is an exact amount you pay for certain medical services or medical supplies, after which the health care plan or insurance company often pays the rest of the charges. Example: You may pay a $20 co-payment for a primary care physician visit.
A provider is any physician, hospital, organization or other person or institution that furnishes health care services and is licensed or otherwise authorized to practice in Florida.
A preexisting condition is an illness or physical condition that existed prior to the policy's effective date and one that the applicant did not disclose on the application. A condition that is noted on the application may be excluded by rider or waiver. Medical costs incurred due to a preexisting condition are excluded from coverage under plans that contain this exclusion. However, this exclusion applies for only a limited time.
A waiver is an agreement waiving the company's liability for a certain type or types of risk ordinarily covered in the policy.
A rider adds something to the policy. The term is used loosely to refer to any supplemental agreement attached to and made part of the policy, whether the policy's conditions are expanded and additional coverage added or coverage of conditions is waived.