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Insurance Glossary: Health, Life, Dental, Vision, Long-Term Care & Annuities

Welcome to our comprehensive insurance glossary, your go-to resource for understanding key terms related to health insurance, life insurance, hospital indemnity plans, dental, vision, and hearing coverage, long-term care insurance, and annuities. Whether you're comparing policies, reviewing benefits, or speaking with an insurance agent, this glossary will help you make informed decisions with confidence.

Each definition is written in plain language to help you better understand your insurance coverage, policy options, and financial planning tools. 

Bookmark this page as a helpful reference whenever you need to decode insurance jargon and take control of your coverage.

A

  • Accelerated Death Benefit: A life insurance feature allowing early payout of benefits if the insured is diagnosed with a terminal illness.

  • Accumulation Period: The time during which annuity premiums are paid and interest accumulates before payouts begin.

  • Actuarial Value: The percentage of total average costs for covered benefits that a plan will cover.

  • Annuity: A contract that provides regular payments for life or a specified period, often used for retirement income.

  • Assignment of Benefits (AOB): Authorization for a provider to bill your insurance directly and receive payment.

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B

  • Beneficiary: The person or entity designated to receive insurance benefits upon the policyholder’s death.

  • Benefit Period: The length of time benefits are paid, such as for hospital indemnity or long-term care.

  • Benefit Trigger: Conditions that must be met for long-term care insurance to begin paying benefits.

  • Broker: A licensed individual who helps clients find insurance policies from multiple companies.

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C

  • Capitation: A payment arrangement where a provider is paid a set amount per patient regardless of services provided.

  • Claim: A formal request for payment under an insurance policy.

  • Coinsurance: The percentage of costs you pay after meeting your deductible.

  • Contingent Beneficiary: The person who receives benefits if the primary beneficiary is deceased.

  • Copayment (Copay): A fixed fee paid for covered services, typically at the time of service.

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D

  • Death Benefit: The amount paid to a beneficiary upon the death of the insured.

  • Deductible: The amount you must pay before insurance begins to cover costs.

  • Dental Insurance: Coverage for preventive and restorative dental care.

  • Disability Rider: An add-on to a life insurance policy that waives premiums if the insured becomes disabled.

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E

  • Elimination Period: A waiting period before benefits begin, common in long-term care and hospital indemnity plans.

  • Evidence of Insurability (EOI): Proof of good health required for some insurance applications.

  • Exclusions: Specific conditions or treatments not covered by a policy.

  • Extended Care Facility: A facility providing long-term care services, often covered under long-term care insurance.

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F

  • Final Expense Insurance: A type of life insurance designed to cover funeral and burial costs.

  • Free Look Period: A time frame (usually 10–30 days) to cancel a policy without penalty.

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G

  • Guaranteed Issue: A policy that is issued without medical underwriting.

  • Guaranteed Renewable: A policy that cannot be canceled by the insurer as long as premiums are paid.

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H

  • Health Maintenance Organization (HMO): A plan requiring members to use a network of providers and get referrals for specialists.

  • Hospital Indemnity Insurance: Pays a fixed amount per day for hospital stays, regardless of actual costs.

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I

  • Incontestability Clause: A provision that prevents the insurer from voiding coverage after a certain period due to misstatements.

  • Indemnity Plan: A plan that reimburses the insured for medical expenses rather than paying providers directly.

  • Insurable Interest: A financial or emotional relationship that justifies purchasing insurance on someone’s life.

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L

  • Lapse: Termination of a policy due to non-payment of premiums.

  • Living Benefits: Access to a portion of life insurance benefits while still alive under certain conditions.

  • Long-Term Care Insurance: Covers services for chronic illness or disability, including home care and nursing facilities.

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M

  • Managed Care: A system that integrates the financing and delivery of health care services.

  • Medically Necessary: Services or supplies needed to diagnose or treat a condition.

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N

  • Network: A group of providers contracted with an insurance company to provide services at discounted rates.

  • Non-Participating Provider: A provider who does not have a contract with your insurance plan.

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P

  • Payout Phase: The period during which an annuity makes regular payments to the annuitant.

  • Policyholder: The person who owns the insurance policy.

  • Pre-Existing Condition: A health issue that existed before the start of a policy.

  • Premium: The amount paid for insurance coverage.

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R

  • Rider: An optional provision added to a policy to provide additional benefits.

  • Return of Premium: A rider that refunds premiums if the insured outlives the policy term.

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S

  • Substandard Risk: A classification for applicants with higher-than-average risk, often resulting in higher premiums.

  • Supplemental Insurance: Additional coverage that helps pay for out-of-pocket expenses not covered by primary insurance.

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T

  • Term Life Insurance: Provides coverage for a specific period and pays a benefit only if the insured dies during that term.

  • Third-Party Administrator (TPA): An organization that processes insurance claims or benefits for another company.

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U

  • Underwriter: A person who evaluates risk and determines policy terms and premiums.

  • Underwriting: The process of assessing an applicant’s risk to determine coverage eligibility.

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W

  • Waiting Period: The time before coverage begins or benefits are payable.

  • Whole Life Insurance: A permanent life insurance policy with a savings component and fixed premium

Alexander Efroymson wearing a suit

Alexander C Efroymson

Humana MarketPoint Sales Agent

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CELL (239) 309-9267 (Call or Text)

EMAIL aefroymson@humana.com

ADDRESS 5237 Summerlin Commons Blvd, Fort Myers, FL  33907

FACEBOOK GulfCoastLocalAgent

PRODUCTS Medicare Advantage, Medicare Supplements, Medicare Prescriptions, Hospital Indemnity, Life Insurance, Long-Term Care, Annuities & Dental, Vision and Hearing plans.
LICENSES AL, FL, IN, KS, KY, LA, ME, MI, MO, NC, NY, PA, SC, TN, VA, WI

We do not offer every plan available in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options.

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