Glossary

A.M. Best Rating

Founded in 1899, the A.M. Best Company is a full-service credit organisation dedicated to serving the financial services industry by providing worldwide insurance ratings and information about international health insurance companies.

Acupuncture

The procedure of inserting and manipulating needles into various points on the body to relieve pain or for therapeutic purposes.

Adverse Selection

Refers to a situation where an individual's demand for insurance is positively correlated with the individual's risk of loss, and the Insurer is unable to allow for this correlation in the price of insurance and may raise premium rates.

Age Limits

An age range in which an insurance company will only accept applications or renew policies.

Annual Limit

See Business International Health Insurance

Applicant

Refers to a person that is applying for international health insurance coverage.

Application Fee

Some insurance companies require a one-time fee to be paid when you sign up for international health insurance. This may be refunded if your application is rejected for whatever reason.

Area of cover / coverage area

The geographic region (the set of countries) in the world where the insured is entitled to claim for medical treatment. This is usually Worldwide or Worldwide excluding USA. Because of the unproportionally high medical costs in the USA, Insurers will demand a higher premium (+ 150% - 300%) if you want to be covered. Some Insurers will have more location specific areas of cover such as Africa, The Middle East, Asia as areas of cover.

Benefit

A broad term which describes any treatment, service or otherwise help under an international health insurance plan that will restore, maintain, facilitate or encourage good health. Benefits are segmented by type (in-patient, out-patient, dental, etc) and carry specific definitions, exclusions and limitations as described in the table of benefits and other supporting documentation.

Benefit Limit

Describes specifically at what point the insurance company will not, or under what conditions reimburse the insured for a specific benefit.

Benefit period

A benefit period is a length of time during which the insured can be reimbursed for the costs of the benefit incurred.

Benefit Rider

Add-on insurance policies that cover health-related services that are not typically covered. For example: an extreme sports rider or a terrorism rider.

Broker (Brokerage)

A company acting as a mediator between the buyer and seller to facilitate the purchase of international health insurance. Brokers match expatriates with international health insurance products that best meet the expatriates needs. The broker is paid on a commission basis but represents the applicant rather than the insurance company.

Business International Health Insurance

International Health Insurance that is specifically designed for groups of people such as businesses and organisations.

Cancellation Period

The period of time within which you are entitled to change you mind and request a refund where applicable in the event you decide to cancel or not proceed with your cover.

Carrier

See Insurance Company / Insurer / Carrier

Chiropractic

Refers to the set of medical procedures and treatments that are employed to relieve pain usually to the joints, spine and trunk.

Chronic Condition

A sickness, illness or disease which has one of the following characteristics:

• is recurrent;
• is without a cure;
• does not respond well to treatment;
• requires prolonged supervision / care;
• leads to permanent disability.

Claim

A request made by the insured or the insured's sponsor to pay for services rendered.

Claim Form

A form sometimes required to be submitted when claiming a refund of costs from the insurance company. Can be paper or digital.

Claims handling

A general term that refers to the ways in which the insurance company deals with the processing of claims . Has it been handled fairly? Has it been settled quickly? Have customers been properly informed about the claims process?

Co-Insurance

Refers to the shared amount of money that you are obligated to pay for covered medical services/treatment. In the table of benefits, you may see something like: "Dental - 20 % Co-Insurance". This means that you must share the cost of dental treatment costs with the Insurer where you will pay 20% of the bill and the Insurer will pay the remaining 80% subject to you remaining within the benefit limit.

Co-payment / Co-pay

Refers to a specific charge that your international health insurance plan may require you to pay for a specific benefit, service or treatment. It is also referred to more loosely as "co-pay". For example, looking up your table of benefits for your plan you may find that you are required to pay $30 for branded prescription drugs meaning that you are required to pay $30 before the insurance company will start paying. Co-payments are popular in USA styled plans.

Commencement date

See Effective Date

Compassionate Home Visit

In the event of a relative passing away some Insurers will cover the cost of an economy class return fare air ticket for you to return home.

Complementary treatment

Refers to therapeutic treatment as an alternative or is outside conventional Western medicine such as Chinese herbal medicine or acupuncture.

Complications of childbirth

This definition differs from Insurer to Insurer however generally this refers to abnormal conditions that arise during childbirth such as postpartum haemorrhage, retained placental membrane and medically necessary caesarean sections.

Complications of pregnancy

This refers to the health of the mother during the pre-natal (preceding) stages of pregnancy such as miscarriage or stillbirth.

Convalescent home

Refers to a medical facility designed to treat and care for patients with long-term or chronic illnesses.

Corporate international health insurance

Refer to Business International Health Insurance

Country of Residence

The principal country in which you spend most of your time year living in.

Cover (Coverage)

A general term describing the fact that the insured is insured. It could refer to a specific benefit or international health insurance broadly.

Coverage Period

The timeframe in which the insured can receive and claim for medical expenses as detailed in his or her international medical insurance policy documentation.

Criminal assault benefit

Provides cover to the insured in the event of physical violence inflicted by another person.

Critical illness

A serious illness or disease categorised by the medical necessity of intensive monitoring and / or life-support treatment.

CT Scan (CAT Scan)

Or computerised axial tomography is a sophisticated x-ray / imaging procedure for showing bone detail primarily.

Day-care treatment

Refer to In-Patient Treatment

Death Benefit

A Death Benefit is an amount that shall be paid should the insured person pass away during the period of insurance as a result of sickness, illness or accident. Restrictions vary from Insurer to Insurer and plan to plan should the insured person(s) have a pre-existing and/or chronic condition(s).

Deductible / Excess

This is the amount of money that you must pay before the insurance company will start paying for medical expenses. Your deductible / excess is subtracted from your reimbursable sum when a claim is made. They can be per sickness/injury, per insurance period or per year and usually applies to each insured member of the policy separately.

For example, assume that you have bought a policy with a deductible / excess of "$500 per person per injury" and that unfortunately you break your leg. You go to hospital and receive treatment costing $1,000. In this case, you would need to pay the first $500 (your deductible amount) and your insurance company would pay the remaining $500.

Denial of claim

This refers to an insurance company refusing to pay for treatment that you received and have submitted a claim for. A denial could arise for many reasons. More information regarding denial of claims can be found here.

Dental prostheses

Amongst other things, dental prostheses usually includes or excludes cover for crowns, inlays, onlays, reconstructions, restorations, bridges, dentures and implants.

Dental surgery

Exact definitions differ from Insurer to Insurer however generally dental surgery refers to extraction of teeth, apicoectomy, treatment for jaw deformities, fractures and tumours. It does not cover surgical treatment that is related to artificial dental implants or wholly cosmetic.

Dependent

Refers to your spouse or partner (husband / wife / same sex partner) and children. Age definitions of children vary from Insurer to Insurer however they are usually eligible to be regarded as a child if they apply up until the day before their 18th birthday. Some Insurers will also accept 'children' up until the day before their 24th birthday if they are enrolled in full-time education.

Diagnostic tests

Refers to tests such as blood tests, x-rays, CT, ultrasound and MRI scans to investigate and determine the cause of patient symptoms. Exact definitions differ from Insurer to Insurer and plan to plan so it is worth checking the table of benefits and other supporting documentation.

Due date

Refers to the day on which your international health insurance policy premium must be paid for your policy to continue. Most insurance companies offer the following payment terms / frequency options: annually, bi-annually, quarterly and monthly. Failing to pay for your policy on your due date may terminate your policy.

Effective date

The date on which international health insurance coverage comes into effect / provides insurance cover.

Emergency Reunion

Is an international health insurance benefit that facilitates the transport of a family member to where you are receiving treatment should you become seriously ill.

Exclusions

Refers to conditions / situations / events which are not eligible for reimbursement under an international medical insurance policy. These usually include things like war, self-harm, terrorism, HIV/AIDS, cosmetic surgery, injuries arising from dangerous hobbies and usually, pre-existing conditions treated in the past two years.

Expatriate (Expat)

A person temporarily or permanently residing in a country and culture other than that of the person's upbringing or legal residence.

Financial Services Authority (FSA)

An independent non-governmental body, quasi-judicial body and a company limited by guarantee that regulates the financial services and insurance industry.

Full Cover / 100%

Found in the table of benefits, "full cover", "100%" or something else to that effect means that you can receive full compensation for the associated benefit up until the policy maximum (overall limit) has been reached.

Group international health insurance

Refer to Business International Health Insurance

Hazardous Sports Cover

Refers to cover for "dangerous" sporting activities such as but not limited to mountaineering, hang gliding, parachuting, bungee jumping, motor vehicle racing, snow mobiling, skiing and snow boarding.

Home country

Is the country for which the insured person holds a current passport and/or to which the insured person would want to be repatriated.

Homeopathy

A form of alternative medicine that attempts to treat patients with heavily diluted preparations which are claimed to cause effects similar to the symptoms presented.

Hospital / Provider Network

A directory / list of medical providers which are recognised by the insurance company and which usually the insurance company has an established relationship with. This is not to say that you cannot go to a hospital of your choice that is outside your insurance company's network but it is usually advantageous to do so in respect of claims handling.

Many Insurers have online hospital network databases where you can easily find information about hospitals close to wherever you are in the world.

Hospital accommodation

Refers to the type of room that you stay in when receiving treatment in hospital. Private, semi-private deluxe and executive suites are common benefits of international health insurance plans.

Hospitalisation

Being placed in medical care at a medical care facility.

In-Patient Cash Benefit

Refers to an international health insurance benefit where monies are paid by the insurance company when treatment and/or accommodation for medical treatment, that would otherwise be covered under the insured's plan, is provided in a hospital where no charges are billed.

In-Patient Dental Treatment

Refers to emergency dental treatment due to a serious accident that requires you to be admitted to hospital.

In-Patient Treatment

Refers to treatment in a hospital / clinic where an overnight stay is medically necessary.

Infertility treatment

Refers to reproductive treatment and technology for either sexes used primarily to achieve pregnancy by artificial or partially artificial means. It may also refer to treatment used to investigate procedures necessary to establish the cause for infertility.

Insurance Certificate

A document which details what you as a policyholder are entitled to. It simply proves that a contractual relationship exists between the insured person(s) and the insurance company.

Insurance Company / Insurer / Carrier

A company that sells insurance to cover the cost or sometimes compensate for loss due to ill health or accident.

Insurance Year

Refers to the effective date (or the date that your insurance commences) of a policy and ends exactly one year later.

Insured Person(s)

A policy holder and other people such as dependents that are subscribed to a policy.

International Health Insurance

Also known as "Private Medical Insurance", Expatriate Health Insurance or International Medical Insurance, refers to insurance designed to provide private medical care in the event of sickness, ill health or accident.

International Medical Insurance

Refer to International Health Insurance

Liability

A hindrance or obligation to pay money to another party.

Lifetime Maximum / Maximum Benefit / Policy Maximum

The maximum amount that the insurance company will pay out during the entire term of the insurance policy.

Loading (Premium loading)

The amount that an insurance company adds to the basic premium to cover those that are applying. Sometimes premium loading is applied during the application process if you would like to cover pre-existing conditions.

Local Ambulance

Is ambulance transport that is required in the event of emergency or otherwise deemed medically necessary to transport an insured person(s) to hospital.

Local Plan

Short hand for private health insurance in countries that are outside an expatriate's home country that is primarily designed to cater to the local population.

Long Term Care

Refers to treatment and care over a long period of time after emergency / acute treatment has been completed. International health insurance plans can offer reimbursement for care at home, in a community, a hospital or nursing home, however, it is important to check restrictions/exclusions.

Managed Care

A broad term used to describe any system that manages healthcare delivery with the aim of controlling costs. In international health insurance this is encouraged by insurance companies through the use of primary care physicians, or by encouraging the use of a specific network of healthcare providers.

Maternity

Refers to cover for medical costs incurred during pregnancy and childbirth, including hospital charges, specialist fees, mother's pre- and post-natal care, as well as newborn care.

Medical Aids

Any instrument or device that is designed to help or increase the function of the insured person. Typically medical aids would include hearing aids, speaking aids, wheelchairs, crutches, braces and artificial limbs. Many Insurers have restrictions/exclusions in respect of these.

Medical Evacuation

Refers to reimbursement to cover transport costs to the nearest suitable medical centre, when the treatment you need is not available nearby. It may also cover additional expenses such as the cost of a return flight back to the insured's principle country of residence.

Medical History Disregard (MHD)

Refers to insurance companies waiving pre-existing conditions of one or more insured members. Typically, group schemes of 20 or more people can offer MHD meaning that members suffering from pre-existing conditions can receive treatment and claim medical expenses that arise as a result of their pre-existing condition or associated conditions.

Medical Necessity

Is the determination that a person requires medical treatment and services.

Medical Practitioner

Is a physician who is licensed to practice medicine under the law of the country in which treatment is given.

Medical Practitioner Fees

Refers to costs / bills arising from treatment performed or administered by a medical practitioner.

Medical Questionnaire

Asked during the application process, this is a document that applicants use to provide details of their medical history such as pre-existing or chronic condition details. It is used in conjunction with the general application form to determine if an applicant is insurable and at what price or not.

Disclosing details of your medical history allows the insurance companies to better assess your case during the application process and can quicken approval.

Medical Repatriation

Refers to a policy benefit that covers costs for transport to your home country to be treated in familiar surroundings. It also sometimes covers costs for the return trip back to your principle country of residence.

Medical Underwriting

The process of determining if you are insurable or not based on your medical history.

Membership

Refers to when you are enrolled on / covered under an international health insurance policy.

Midwife Fees

This refers to fees charged to assist women during pregnancy, labour and postpartum period by a midwife (birth assistant).

Moratorium Cover

Moratorium cover refers to after a period of time has elapsed of continuous cover, some pre-existing medical conditions will become eligible for benefit. Pre-existing conditions will be covered after a set period only if you haven't consulted with any doctor or specialist for advice or treatment or if you haven't suffered any symptoms for that medical condition or any related condition for a continuous period determined by the Insurer.

Moratorium cover allows you to get cover for pre-existing conditions provided that your condition appears to have fully subsided.

MRI Scan

Magnetic resonance imaging is primarily used to visualise the internal structure and function of the body. It provides detailed images of the body in any plane. MRI has much greater soft tissue contrast than Computed tomography (CT) making it especially useful in neurological diseases.

Natural Disaster Benefit

Provides cover in the event of natural disasters such as floods, tornados, volcano eruptions, earthquakes or landslides.

Newborn Care

A specific medical maternity benefit associated with examinations and diagnostic test required to determine the health of a newborn child. They are carried out immediately following childbirth. Some plans but not all, also include more comprehensive diagnostic newborn tests such as blood type and hearing. If problems are discovered, then sometimes Insurers may include cover for more complex medically necessary treatment and diagnostic tests.

No Claims Discount

Refers to a discount that you can potentially receive should you renew your policy on condition that you haven't filed any claims over the insurance year. Not all insurance companies offer a no claims discount.

No Cover

Found in the table of benefits, "no cover" refers to a specific benefit that the insurance company will not provide reimbursement for.

Nursing at home

Refers to treatment and / or care at your home typically for patients that require long term attention or those suffering from chronic conditions.

Occupational Therapy (OT)

Refers to treatment and care associated with the development and/or restoration of fine motor skills, sensory integration, coordination, balance and other day-to-day skills such as dressing, eating, grooming, etc.

Oncology

Refers to treatment associated with tumours such as diagnostic tests, radiotherapy, chemotherapy and other hospital fees associated with the treatment of cancer.

Orthodontics

The dental practice and use of devices to restore teeth to proper alignment and function.

Orthomolecular Treatment

A form of complementary medicine that aims to prevent or treat diseases by correcting cell deficiencies on the molecular level with nutrients prescribed such as vitamins, minerals, enzymes, hormones, etc.

Osteopathy

Treatment based on the manipulation of bones and muscles.

Out of Area Cover

Refers to emergency treatment and services that are outside your geographical area of cover (US, Canada, Europe, etc) that are nonetheless deemed eligible for reimbursement.

Out-Patient Surgery

A surgical procedure performed in a day-care or out-patient facility that does not require you to stay overnight in hospital.

Out-Patient Treatment

Refers to treatment provided in the practice or surgery of a medical practitioner, therapist or specialist that does not require the patient to be admitted to hospital.

Parental Accommodation

A benefit designed to provide cover for reasonable costs incurred by parents when having to stay in accomododation due to their child being admitted to hospital.

Payment Terms / Payment Frequency

International health insurance premiums can usually be paid for on a monthly, quarterly, semi-annual or annual basis. The lower the payment frequency, the lower your premium will be.

Periodontics

Refers to dental treatment related to gum disease.

Policy / Plan

Is a contract between the Insurer and the Insured which determines medical treatment, medical services and associated treatment claims which the insurance company is legally required to pay.

Policy Holder

The person who owns or is subscribed to an international health insurance policy.

Policy Wording

The policy wording is the exact offer from the insurance company to you. It is usually a document that contains full terms and conditions of the coverage offered, including any applicable exclusions, conditions and limitations to cover. It is always recommended you read this fully.

Post-natal Care

Refers to medical treatment received by the mother, the child or both after birth.

Pre-certification

Is a general term referring to the requirement that the insured must obtain authorisation / approval from the insurance company before proceeding with treatment if the treatment is to be deemed eligible for reimbursement.

Pre-existing Conditions

Medical conditions or any related medical conditions for which one or more symptoms have surfaced over a number of years (usually 1-5 depending on the Insurer) prior to commencement of cover.

Pre-natal Care

Treatment for women during pregnancy/prior to childbirth such as diagnostic tests.

Premium

The amount made payable to the insurance company according to your policy wording. Typically premiums can be made on a monthly, quarterly, semi-annual or annual basis. Premiums are determined by the Insurer based on a variety of factors but primarily age, level of cover, geographical area of cover, and country of residence.

Prescription Drugs

Pharmaceutical drugs available only on the prescription of a registered medical practitioner and available only from pharmacies.

Preventative Treatment

Refers to treatment that is undertaken without any symptoms being present at the time of treatment in order to promote and encourage good health to thereby prevent ill health.

Primary Care

A broad term referring to routine care of common health problems and chronic illnesses that can be managed on an out-patient basis.

Psychiatry

Cover associated with the diagnosis and treatment of mental disorders.

Psychotherapy

Refers to personal counselling used to treat problems of living such as depression.

Reconstructive Surgery

Surgery used to restore function and tissue form to the body such as plastic surgery.

Rehabilitation

Refers to treatment aimed to restore normal form and function after a serious illness or injury.

Reimbursement

Amount of money that you receive for a claim, expenses, damages or losses as determined by your Insurer.

Reinsurance

This refers to where an insurance company policy enters into an arrangement with another insurance company to cover some or all of the benefits that are payable to the policyholder. It is used to spread risk.

Renewable

Simply means that an international health insurance policy can be renewed / extended.

Renewal Date

The date on which your international health insurance policy will expire unless extended (renewed).

Repatriation

To return to your home country on a permanent basis.

Repatriation of Mortal Remains

Refers to the transportation of the deceased’s mortal remains from the country of residence to the country of burial.

Routine Health Checks

Refers to tests and screening performed when no medical symptoms of illness are present. They are used as a preventative and early warning mechanism to promote and encourage good health and can include things like checking vital signs, the cardiovascular system and cancer screening.

Routine Maternity

Refers to medical costs incurred during pregnancy and childbirth such as hospital accommodation, fees associated with normal pregnancy and midwife fees.

Schengen Visa

Is a specific visa type that allows the holder to travel to any or all Schengen member countries under one single visa. Currently there are 15 European member countries: Austria, Germany, Belgium, Denmark, Finland, France, Greece, Iceland, Italy, Luxemburg, Norway, Portugal, Spain, Sweden and The Netherlands.

Specialist

An expert doctor / physician that specialises in a particular branch of medical science.

Specialist Fees

Expenses associated with consultations or treatment by a specialist.

Speech Therapy

Refers to treatment that is intended to correct speech disorders.

Student International Health Insurance

Specific international health insurance plans that are designed for and cater to international students.

Substance Abuse

Refers to the excessive use and usually dependence on drugs that are detrimental to health.

Surgical Prostheses (Surgical Appliances)

Refers to artificial body parts or devices that are medically necessary following surgery.

Term life insurance

A life insurance policy that is in effect for a set number (a term) of years which pays out a defined amount in the event of death.

Terrorism Benefit

Refers to cover for injuries and illnesses that arise from an act of terrorism.

Therapist

Someone who provides therapy (care) for someone.

Travel Insurance

Travel insurance is designed for holiday makers and those travelling for less than one year. Travel insurance does not provide comprehensive levels of cover and usually provides only basic forms of emergency in-patient treatment benefits.

Furthermore some of the benefits that travel insurance provides are different to international health insurance such as cover for lost baggage or missed departure.

Treatment

Refers to any medical procedure or practice with the intention of curing or relieving illness or injury.

Trip Cancellation

Refers to a benefit that provides reimbursement for trip payments and deposits if a trip is cancelled for illness, death or other specific unforeseen circumstances.

Trip Interruption

Refers to a benefit that provides reimbursement for trip payments and deposits if a trip is interrupted for illness, death or other specific unforeseen circumstances.

Underinsured

Refers to those that do not have sufficient insurance to cover loss or damage adequately enough.

Underwriter

See Insurance Company / Insurer / Carrier

Underwriting

Refers to the process that an insurance company uses to assess the eligibility of an applicant to get approval for international health insurance.

URC (Usual, Reasonable and Customary)

This refers to the standard or most common charge for a particular medical service when rendered. It is often seen in table of benefits meaning roughly that the Insurer will pay out whatever amount is usual or reasonable for that specific benefit.

Vaccinations

Refers to immunisations and booster injections in addition to the cost of consultation for administering the vaccine.

Waiting Period

A period of time during which you are not entitled to cover for particular benefits.