Insurance Glossary

Need to find out what something means? Try finding it in our glossary.The following does not replace the terms and definitions found in your school-sponsored health insurance plan policy. Please make sure to consult your school-specific web site on the Student Connection for specific terminology as it relates to your school health insurance plan benefits.

Accidental Death & Dismemberment (AD&D)

Payment to the insured person or his beneficiaries (usually family members) if an accident causes either the death of the insured or to lose body parts.

Add-on plan

Add-on Plan is an optional benefit. The Add-on Plan within Patriot Exchange Program Plan includes airport luggage/personal belongings lost or stolen, Legal assistance, the third party liability and high school sports.

Benefits

The maximum that the insurance will provide for treatments or services in per policy year.

Co-pay

This is the amount of money you must pay out of pocked for certain medical services.

Coinsurance

Coinsurance is a percentage of what the insurance will pay to cover your health care cost after any deductibles or copays have been met. If you have an insurance policy with a 80% coinsurance, the insurance will pay 80% and your share of the cost would be 20% (if there is no deductible or copay on the plan).

Deductible

The Deductible is the amount that you must pay to the doctor or hospital before the insurance company begins paying any benefits. And is typically paid at the time of treatment. If you return to the physician or hospital for the same sickness or accident, you do not have to pay the deductible again.

Emergency Evacuation

Transport the patient who's illness is very serious to the nearest qualified medical facility, or his home country.

Maximum lifetime medical benefits

The total amount payable by the insurance company for covered medical expenses due to injury or sickness per policy lifetime.

Maximum per injury or sickness

The total amount payable by the insurance company for covered medical expenses for injury or sickness per medical event.

Outpatient treatment

A medical treatment received without being admitted to a hospital.

Out of pocket limit

Maximum amount of money you paid during a policy period for covered treatments or services according to the benefit limits of your plan.

Prescription Drug

Benefits for the purchase of drugs and medicines prescribed by a physician and the insured need to buy it in pharmacy.

PPO network

A network of doctors, clinics, hospitals and related medical service providers. The network can provide health care at a discounted or a favorable price.

Pre-certification

The insured must obtain pre-authorization or approval from the insurance company before you get some specific services.

Pre-existing condition

Pre-existing conditions include any medical conditions or any related medical conditions before the effective date of your insurance.

Repatriation of Remains

When the insured died abroad, the insurance company should pay the expenses for returning the body of insured back to their home country.

URC

Usual, Reasonable and Customary (also known as URC) is the average cost for a particular treatment in a particular geographic area.

Yearly/annual maximum

The maximum amount of compensation provided by the insurance in each policy year for treatment or service.