10 important international health insurance terms
Understanding international health insurance terms is necessary, especially if you are buying that insurance. This type of insurance reimburses you for medical expenses incurred in the event of illness during your stay abroad.
You may already be familiar with a few basic terms in our other article on international health insurance terminology. Here are another ten important international health insurance terms explained below for your easy reference:
A written contract between two parties (insurer and the insured) is known as a policy. This stamped document lists out the features and benefits of the insurance policy.
You file a claim when you apply to the insurance company to reimburse expenses incurred on medical treatment. Very often this process is delegated to a ‘Third-Party Administrator’ (TPA).
Third-party administrator (TPA)
TPAs are authorized by the insurance company to settle claims. They examine the proof submitted by way of expenses incurred against the actual coverage as per the policy taken.
You have to interact with third-party administrators for settlement of your claim. Before approving your claim, they check whether it is compliant with the terms and conditions of the relevant policy.
Also referred to as ‘sum assured’ and ‘sum insured’, coverage amount is the amount payable when a claim is filed. It is the maximum amount an insured party can hope to receive after filing a claim.
This term basically refers to the insurance policy cost. Premium is an amount paid at fixed intervals by the buyer of the policy to the company issuing the policy. The actual premium to be paid is determined on the basis of the coverage amount you choose.
For each year you do not file any claims, you stand to benefit by way of a cumulative bonus. Your overall sum insured and the premium paid is taken into account to arrive at your entitlement of additional bonuses. As specified in your policy, the amount of such benefits falls within a certain percentage.
The specified amount you pay out of your own pocket to the doctor or hospital is referred to as a deductible. Later, you can access the medical benefits of your policy and the insurance company will begin paying towards covered expenses. For the duration of your coverage, this deductible amount is reset at the beginning of each year.
After paying a deductible, the percentage split arrived at is referred to as medical coinsurance. Commonly, 80 percent of the healthcare cost is borne by the insurance company. The remaining 20 percent of this service cost is paid by the person insured.
A group of medical providers who have entered into a deal with the concerned insurance company forms the provider network. They provide healthcare services at discounted rates to the insured and even accept direct payment from the insurance company.
If the policyholder passes away during the validity of the insurance plan, the beneficiary receives the accrued insurance benefits. For this purpose, register the name of the concerned beneficiary at the time of taking the expat health insurance.
It is important to note that the more you delay in taking a health insurance policy, the more money you pay owing to the increased risk factor. The medical history and age of the person buying the health policy determine the coverage amount and subsequent premium.
At Expatmedicare, your health is our primary concern. We hope these important international health insurance terms help you understand your insurance better.