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HEALTH INSURANCE

MORE TERMS

These are the other insurance terms that are beneficial for everyone to know and understand. Having knowledge of exactly what these terms mean will guarantee that you have an easier time finding the right health insurance plan. 

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Insurance Policy

A document that lists the terms and conditions of an insurance contract.

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Provider

A person or place where a person can receive licensed health care. This includes doctors, nurses, hospitals, long term care facilities, mental facilities, and much more.

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Carrier

A term for an insurer/insurance company.

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Network

A group of healthcare providers, such as doctors and hospitals, that agree to a negotiated (i.e., discounted) rate for services provided to the members. Some plans pay out benefits for both in and out of network providers, but some only pay for providers in network. It is important to know which option applies to you before enrolling.

Pre-Existing Condition

Any health problem, mental or physical, that an individual had before a new health insurance plan begins. Depending on the plan, the underwriting process may check for pre-existing conditions diagnosed within 10 years, 5 years, 6 months, or another specified date.

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Enrollment Fee

A one time payment required in order to enroll with some plans. Sometimes they are required, sometimes they are not, and sometimes a broker can waive the enrollment fee for you.

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Free Look Period

A period of time specified in insurance policy that allows that contract holder to cancel their policy and receive a full refund of their premium. A free look period lasts a minimum of 10 days , but could be more depending on the insurer and state law.

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Underwriting

A process that insurance companies use to determine an applicant’s health status/pre-existing conditions when they enroll in a plan. 

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