Russia Health Insurance Coverage Definitions
This page can help you better understand the terms, definition and some exclusion often used in medical and health insurance plans.
What is Insurance?
Insurance is a tool for adequate risk management, functioning through a transfer of the risk to insurance provider in exchange for a preordain fee.
What is Health Insurance?
In this light health insurance serves to assign costs of incurred medical expenditures to an insurance provider in return for yearly (or monthly) payments. In the event of illness or an accident insurance company takes on the financial responsibility for medical fees incurred.
With the above two terms clarified, below you will find basic term in the alphabetical order that are present in the majority of health insurance policy plans. By acquainting yourself with them you will be able to make more informed and knowledgeable decision.
Acute Illness: Malady or sickness with a rapid onset yet short in its duration.
Anniversary Date: In the context of insurance policies the term refers to either insurance policy's renewal date or the anniversary of an inception date of any particular plan or policy.
Applicant: a person, company or a group wishing to attach themselves to an insurance plan or policy
Application: necessary documentation used for acquiring medical and health insurance
Claim: Refers to a request or demand by the insured person for the payments or benefits promised under his or her insurance plan
Commencement Date: the activation date of an insurance policy
Deductible: A threshold amount, foreseen by the contact, that is payed by the insured party prior submitting any claims under the insurance policy.
Documents: Records containing information, that is authorized or legally recognized
Due Date: The date when the premium is scheduled for payment.
Hospitalization: Refers to an insurance option that, depending on the plan, covers partly or fully expenditures incurred for being admitted to and/or treated at the hospital.
In-patient: Term that refers to an overnight stay at a medical facility due to required medical treatment.
Out-Patient: Term that refers to a treatment not requiring an overnight stay at a medical facility.
Policy Conditions: Terms of the agreement that govern the insurance contract.
Policyholder: Under individual or family plan, policyholder refers to an individual to whom the policy has been issued. In the case of the group purchase plan policyholder is either the employer or a trustee.
Policy Schedule: Is a comprehensive document that contains the information on level of coverage and outlines appropriate sections of the policy material to support the above.
Pre-existing Condition: Any illness or a health condition that existed before the insurance policy was purchased. Certain policies outline conditions in the contract that rule out coverage for any future loss or issue that arises from a preexisting conditions.
Reimbursement Rates: The ultimate amount payed per year covering medical costs for a particular health insurance policy
Region: The geographical area where you choose to and subsequently are entitled to be covered.
Renewal: recommencement of an existing insurance policy for a further period of time.
Serious Injury: the term can refer to any of the following: fracture, dismemberment, permanent limitation or loss of use of a body part, organ, body function or system; significant disfigurement. It may also refer to an injury of an impermanent nature which substantially limits the person's usual daily activities. Alternatively the term may also refer to an injury resulting in death;
Special Terms: particular premises, terms and regulations outside the usual policy condition
Standard Terms: premises, terms and regulations outlined in an insurance policy
Subrogation: The right that the insurer may exercise in recovering a payed claim from a third party fully or partially responsible for the happening of an insured event.
Surgery: Procedure performed for the purpose of treatment of an injury, deformity or a disease.
Terminal Phase: A stage in the illness development after which the patient can no longer be cured or adequately treated, with curtly followed death as a result.
Waiting Period: Amount of time, agreed upon in the contract, that must pass before the insured will be able to make a claim. If you wish to know more about Waiting Periods, please click here.
Russia Health Insurance Exclusions
You have to be aware that most of health insurance plans have a number of medical conditions and treatments that are excluded from the coverage. The list of exclusions generally depends on the plan and the insurance provider, nevertheless the are certain aspects that tend to be excluded more often than others. In that light pre-existing medical conditions unless specified otherwise are often excluded from any medical and health insurance policy. Please find the exact definition of the Pre-Existing Conditions in the list above or follow the link Pre-existing Condition Insurance Coverage.
Below you may find the list of medical conditions that tend to be excluded more often from health insurance plans:
- Conditions related to the use or abuse of Drugs (Narcotics) or Alcohol.
- Experimental Treatments with no proven treatment record.
- Fertility Testing and Treatment, such as IVF, unless otherwise specified.
- Cosmetic Surgeries or cosmetic procedures: Plastic Surgery.
- Psychological Conditions and Treatment.
- Early Termination of Pregnancy: Abortion.
- Treatment for HIV/AIDS.
- Sterilization and other forms of contraception.
- Sexual Dysfunction: Impotence or Erectile Dysfunction.
- Treatments related to morbid obesity.
- Epidemics and Pandemics under the direction of the Authorities (WHO, CDC, etc).
- Injuries as a result of a terrorist act.
Remember that while the above list of exclusions is an industry staple, there are certain insurance plans that may cover some of the above conditions. Take time to consult with your insurance provider to learn more about any specific plan and its terms and conditions. Alternatively you may contact us at Russia Health Insurance to gather more information.
Russia Health Insurance Information
If you wish to know more about any specific terminology, exclusion or gather more information on what sort of health insurance plan would address your needs best contact Russia Health Insurance for more information.