Glossary of Terms

Premium: The amount you pay to your insurance provider on a regular basis (monthly or annually) to maintain your private health insurance coverage.

Policy: The contract between you and the insurance company that outlines the terms, conditions, coverage, and benefits of your health insurance plan.

Excess: The amount you agree to pay out of pocket before your insurance coverage starts to cover the costs of medical treatment.

Inpatient: A patient who is admitted to a hospital or healthcare facility for treatment and requires an overnight stay.

Outpatient: A patient who receives medical treatment or services at a hospital or healthcare facility without requiring an overnight stay.

Underwriting: The process by which an insurance company assesses the risks and determines the premiums for an individual’s health insurance policy.

Pre-existing Condition: A medical condition that existed before you obtained private health insurance coverage. Some plans may have waiting periods or exclusions for pre-existing conditions.

Benefit: The medical services, treatments, and procedures covered by your private health insurance policy.

Exclusion: Specific medical services, treatments, or conditions that are not covered by your insurance policy.

Waiting Period: The time period you must wait after purchasing a policy before you can start making claims for certain benefits, such as coverage for pre-existing conditions.

Renewal: The process of extending your health insurance policy for another term after the initial coverage period ends.

Claim: A formal request you make to your insurance company to cover the costs of eligible medical expenses.

Hospitalisation: The process of being admitted to a hospital for medical treatment and care.

Specialist: A medical professional with expertise in a specific area of healthcare, such as a consultant surgeon or consultant physician.

Diagnostic Test: Medical tests or procedures conducted to identify or diagnose a medical condition, such as blood tests, X-rays, or MRI scans.

Out-of-Pocket Expenses: The costs you have to pay directly, including deductibles, co-payments, and any non-covered services.

Cash Benefit: A fixed payment made to you by the insurance company to cover a specific medical treatment or service, regardless of the actual cost.

Chronic Condition: A long-term medical condition that requires ongoing treatment and management, such as diabetes or asthma.

Second Opinion: Seeking advice from a different medical professional to confirm or provide an alternative perspective on a diagnosis or treatment plan.

NHS Top-up Insurance: Private health insurance that covers additional medical services and treatments on top of the services provided by the National Health Service (NHS).