Health insurance documents may use terms that affect when and how a claim can be considered. Their exact meaning depends on the policy wording, so use the insurer's current documents as the authoritative source.
Terms to review
- Waiting period: a specified period before particular benefits may apply.
- Pre-existing condition: conditions defined by the policy that existed before coverage began.
- Co-payment: a share of eligible expenses that the insured may need to pay.
- Room limit: a policy condition that may restrict eligible room charges.
- Network hospital: a hospital included in an insurer's network at a given time.
- Exclusion: a circumstance or expense that is not covered under the policy.
Before you purchase
Check limits, sub-limits, exclusions, claim procedures and the current network list. Ask the insurer to clarify any clause you do not understand.
Important: This article provides general educational information only. It is not a policy summary or personal recommendation. Policy terms, exclusions, eligibility and claims are governed by current official insurer documents.